Professional Documents
Culture Documents
OT Permit For Topoyo
OT Permit For Topoyo
OVERTIME PERMIT
Permit No. ABB/MBU-OT/XI/2019/….. HSE Submitted on (Date)
Company Requester Supervisor Valid from (time) AM / PM
Permit Holder/Req. No. of Manpower Valid To (time) AM / PM
Work Area Work Location Type of Work CW / HW / WAH / CS / Elect
DESCRIPTION OF WORK
MANPOWER LIST
1 8 15. 22. 29.
2 9 16. 23. 30.
3 10 17. 24. 31.
4 11 18. 25. 32.
5 12 19. 26. 33.
6 13 20. 27. 34.
7 14 21. 28. 35.
I HAVE READ, UNDERSTOOD AND CHECKED CONDITIONS WHERE THE JOB CAN BE DONE SAFELY AND AGREE TO OBEY ALL PRECAUTIONS STATED
IN THE PERMIT.
SAYA SUDAH MEMBACA, MENGERTI, MEMERIKSA KONDISI DIMANA PEKERJAAN DAPAT DILAKSANAKAN DENGAN AMAN DAN SETUJU UNTUK
MEMATUHI SEMUA KETENTUAN YANG TERTULIS DI IJIN INI
Signature
Name Name
Signature Signature
Company Company
Date and Time Date and Time