Document NO.

: TT11034PF-CPFII-SAF-GEN-5001-C


VEN-P-001-HSE-T10

ELECTRICAL WORK PERMIT
Permit No: Type of Work:
Date: Location:
Task Supervisor Name: Signature:
Company:

No. of Workers:
Expected work period: From hrs. To hrs. Date:
Equipment & Tools to be used:
Safety Checks Y: Yes N: No N / A : Not Applicable
Precautions Checklist Y N NA Remarks
Provision of barriers


Warning notices posted


All switch boxes double locked up


solation plan provided


Earthing provided


Safety instructions given to workers


Necessary PPE provided (isulating rubber gloves, boots, mats)


Access to work area controlled


Permit Approval: is given after the location where the work is to be done is examined
Validity of the Permit From hrs. To hrs. Date:
Approved by Safety Engineer, SE/Name: Date/Time: Signature:

Prepared by Supervisor/Name: Date/Time: Signature:


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