ELECTRICAL WORK PERMIT

(Permit No.: EW-GI-9087) 1 of 2

Details of Work: ELECTRICAL WORKS
Work Location: GIA – Site Areas
Expected Work Period: From 06.00 AM hrs To 09.00PM hrs Date: 03 July 2009
Other Permit Required: N/A
Task Supervisor Company/Name: GIA -B.D. Woong, K.H. Gon, B.C. Mun, J.S. Won Signature:
Equipment & Tools to be used: VOLT METER,AMMETER No of Workers: 2
Safety Checks : Yes
Item Y N NA Remarks
A. Work Requiring Isolation
Isolation plan provided 
Approved Work Method Statement Provided 

All switch boxes double locked up 

Warning notices provided 
Work area fenced or roped off or screened 
Apparatus dead proved by test 
Earthing provided 

Other necessary precautions 

B. Work on Live Equipment
Approved Work Method Statement provided 
Safety equipment provided 

- Insulating rubber gloves 

- Insulating rubber boots 
- Insulating rubber mats 
- Other tools and equipment 
Danger & caution notice posted& Access Controlled 
Safety Training Provided 
Other necessary precautions 

Special Note
Any Electrical work that requires isolation will have a Checklist for the Electrical Isolation Certificate and will be duly signed and
witnessed by the Contractor Electrical Engineer responsible for the work.

Permit Approval
Validity of the Permit: From 06:00am hrs. to 09:00pm hrs. Date: 03 July 2009
Reviewed by (Contractor Line S/V) Name: S.W.LEE /SHAIKE Signature:
Control Check by (Contractor Safety Supervisor) Name: S.Y.HUH / HYEON.SO Signature:
Approved by Name: H.C. NOH Signature:
Received by (Subcontractor S/V) Name: Signature:
Attachment
Permit Revalidation
 Revalidated Time: From hrs To hrs Date :
Approver Name H.C. NOH Signature
Permit closure
Closed by (Receiver)Name: Date/Time closed: Signature:
(Approver)Name: H.C. NOH Date/Time closed: Signature:

Pre-work Meeting Attendance:

Contractor (Name & Signature) Subcontractor (Name & Signature)
1. 1.
2. 2.
3. 3.

Distribution:

White copy - Keep by Subcontractor (at application)

Yellow copy - Keep at Contractor office
Red copy - Display at work site → File at Contractor office (after closure)