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General Work Permit Template for Kolkata

This document is a general permit to work form for a project in Kolkata, India. It lists various construction tasks like bar bending, masonry works, and excavation that require a permit. It also requires personal protective equipment and equipment isolation details to be provided before work can start.

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sttkolkata
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1K views1 page

General Work Permit Template for Kolkata

This document is a general permit to work form for a project in Kolkata, India. It lists various construction tasks like bar bending, masonry works, and excavation that require a permit. It also requires personal protective equipment and equipment isolation details to be provided before work can start.

Uploaded by

sttkolkata
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Project- Kolkata DC 02

General Permit to Work Form


PERMIT No: - STT/GP- Date: -
Work Location: - Time From: - Time To: -

The tasks below apply to the work: Describe Work, Tools,


 Bar bending/Cutting and Hazards.
 Masonry works Only the below work is to be done and the
tools /
 Survey Work
Equipment listed used.
 Excavation (below 02 mtr.)
Work:
 Electrical Works
 Drilling/Grinding
 Painting works
 Form Work Tools:
 HVAC works
 Plumbing works
Hazards:
 Material handling
works
 Energizing/isolation
Other (Specify):

The below requirements must be in place before work starts and remain in place during the work
Personal Protective Equipment (PPE) appropriate to the task at hand shall be worn/used at all times.
Circle below any PPE that applies to this job.
Safety Eye Hearing High visibility
Gloves Hard hat Safety harness
footwear protection protection vest

Welding
Face Shield
Hood
Fire extinguisher(s) located at:
Requirements to be in place:
Equipment Isolation Responsibility
(Attach list of Isolation details as required)
Equipment to be Isolation Established by: Isolation Withdrawn
Isolated: by:
Electrical / Date
Mechanical /
Fluid

Grant of Permit and Extensions

Yes/NO

Name & Signature of Issuing Authority: -

Name & Signature of EHS Person: -

Verified By: -

C &W/STT Execution Team: - C & W/STT EHS Team:

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