Form No / REV No F/PA/26, 00
WORK PERMIT FOR ELECTRICAL WORK Porcedure No SPR-02
Effec. Date 11.05.2018
Put wherever Applicable
This permit is Mandatory for all contractors such as Electrical Work
New permit Permit extension Permit No.
Location of Work :
Permit Issue Date and Time :
Contractor's Name :
No of employees : Permit Closing date and Time
Nature of work :
Identify the hazards & risks in the work ( Write Yes/ No ) Safety Checks/Guide line for this particular work
W
Risk of falling from height : oThey should have all PPE related to his
rwork
W
Risk of object falling from height on oThey should aware about our work
head: rcondition
W
o
Foot injuries possible:
rAccess for work
W
Hand injuries possible: ochecks all safety parameters like LOCK
rOUT TAG OUT
W
oWorkmen should know deep knowlege
Chance of eye injuries : rabout device / electrical circuit / electical
kconnections etc.
W
Slippery floor :
o
W
Chances of fire : o
W
Chances of Suffocation o
W
Chances of Electrical shock o
PPE for this particular work
Safety Helmet Safety goggles
Face Mask Safety shoes
Hand gloves Ear Plug
Full Body Harness
1 Is the risk & hazards explained to contractor
2 Is the emergency response plan made known to contractor
3 Is the EHS requirements made known to contractor
4 Availability of fire extinguishers ; first aid boxes made known to contractor.
Declaration by the contractor
I have understood the EHS requirement of EPPL, I will follow the instruction given to me and I will take the responsibility to safe working in EPPL
site.
Contractor : Permit initiated by : Dept Head EHS / HR Dept.
Permit closing
After Completion of work permit should be closed
I certify that I have completed the work specified in this permit. All my workmen and equipment have been removed from vicinity of the above work
and all genrated waste are disposed in proper manner as per hazardous waste rule
Contractor : Permit initiator Dept Head EHS / HR Dept.