damansara

GtO DAMANSARA SDN BHD SUPPORTING DOCUMENT DOC NO:

REV 4
OPERAT]ONS DEPT PERMIT TO WORK
DATE 31.05.20r9

21 Controclors ore not ollowed to smoke of working oreo, inside lift, lift lobbies, electrico rooms, M&E riser rooms,
mechonicol rlser rooms ond stoircoses, ond whiie working with hozordous or highly flommob e moteriol, chemicol
or gos.

22. A moteriols, conloiners. toois, equipment covers, boxes, wroppers, pocking, scoffolding ond the like broughl
into the work oreo sho I cleorly beor the controctor's compony nome for eosy idenlificotion. Any item thot does
not ceorly ond conspicuously beor the compony's nome wi lbe considered os uncloimed moteriol ond sholl
be removed os debns without notice.

23. Any electric power topped from the building sholl be done through o portoble distribution boord thot hos on
ELCB roted ot 0.1 A or less.

24. Drilling, cutiing or chosing of ony openings of crny description on ony port of the bul ding superstructure or loocl
beoring structure is NOT ollowed. Prior opprovol sholl be obtoined from Glo Domonsclro Ntonogement if ony of
the obove octivities ore deemed necessory.

25. Any drifting dust oround ihe work site sholl be cleoned immediotely, foiling which the cleoning work moybe
done by G o Domonsoro oppointed cleoners ond oll costs incurred sholl be deducted from the deposil ond/or
chorged to the controctor including ottendcrnce fee.

26. Gorboge ond debris sho I be tronsported out of the building on doily bosrs, foiling which Glo Domonsoro moy
remove the gorboge ond/or debris ond oll cost incurred sho I be deducled from deposit ond/or chorged to the
controctor including ottendonce fee.

27. Controctors ond workers ore PROI-llB1TED from using the possenger lifis.

28. Controctors ond workers con only use service lifts for tronsporiing ony equipment. moteriols, lools, lodders,
construction debris, rubbish, mochines, chemicols or ihe likes from one f oor to onolher.

29. Looding ond/ or un ooding of moterio shol be ot the looding boys ot Looding Boy Block B orl ond Loocling Boy
Block C os stoted on the permii.

30. A forms of nuisonce but nol limited to ihe fol owing sho I be contro led: - noise, noxious fumes, mojor impoct on
to s obs ond wol s, drifting dust, excess fluid.

31. Controctor must submit completed Sysiem Shutdown Form (CONT - F - 03) to Gto Domonsclro Monogement
Office for opprovol 48 hours b,efore the shutdown time. Without opprovol, no system shul down is ollowed.

32. Controctors ore prohibited from corrying out ony moss produciion works such os moss fobricotion of ports, moss
shoping or moss sproy pointing of porls or joinery works, furniture work on the floor.

33. All relevont document (Meihod Stotement, Schemotics plon /work schedue) need to be ottoched wilh this
opp icotion form. ( Note: Any renovotion work neecj 1o submit drowing for opprovol before PTW opplicotion)

34. All opplicotions need to be submilled to Glo Domonsoro for opprovol ot minimum three (3) doys in odvonce
before storting of works.

35. The terms ond conditions stoted in this permit to work is subject to chonges without pnor nottce.

35. Thisworks permit is outomoticolly void if the controctor, his or her workers, supervisors, ogents or representotves
vio otes ony terms ond/or conditions. They will be ordered to leove ihe site immediotely.

Nole: Any breoch by q conlroclor of lhe solety requiremenl (individuol) sholl result in enlorcement chorges levied on,
such individuol, refer otlochmenl on Penolty System.

APPI-ICANT'S DECLARATION:

Ihove reod ond fully understood the terms ond conditions stoted, occept oncl sholi obicie by oll the terms ond conditions
stoted herein. ,7
Applicont's Signoture Dote:
gr /r fe"rl
Designotion Jr. 2ay)Jr r

4
 damansara

GLO DAMANSARA SDN BHD SUPPORTING DOCUMENT DOC NO:

REV 4
OPERAIIONS DEPT PERMIT TO WORK
DATE 31.05.2019

PENATTY SYSTEM
The following ore the penolties of eoch violcrtion. The penolty system will be strictly enforced on o doily bosis:

NO. DESCRIPTION rINA! AMOUNT

I Foilure to weor oppropriote protective equipment while working or RM r00.00
being preseni ot site
2. Performing hot work wiihout hot work permit RM 500.00

3. Using or Woking on unsofe scoflold RA^ 200.00

4. No oppropriote or odequote lodder while working on high level RM 200.00

5. No odequote ond proper borricode ond outhorized removol RA 200.00

6. Using electrico equipment:

i. With dcimoge poris or cob e RM 200.00

ii. With unsofe coble connection
RM 200.00
iii Without eorth leokoge circuit breoker (ECLB) & proper
eorthling instolled or portoble generolor RM 200.00

7. Working in the confined spoce, tonk vessel, monho e or sewer wiihoul RM 500.00
outhorizotion
No compLying with lnstructions pertoining to security, sofety ond RM 500.00
heolth ond environmentol issues
9. Poor Housekeeping ond mointenonce RM 300.00

10. Loss of security poss RM 50.00

t1 Fighting or performing ony illegol octivities within the work site IMMEDIATE DISMMISSAL

FOR OFFICE USE ONTY

(To be filled in by ihe person outhorising the work)

This Permit To Work is volid : From to

Working time ollowed : From until / 24 hoo$

ci- Out s'olf i^ cnorges i'or7:
-_
So'e-y tn6-61 6^ Briefing hod beer cond.-rc led on

Nofe:

No noisy works, wel works ond dusfy works should be done dwing Glo Domonsoro operoting hours. Confrocfors ore
requhed to obtoin worker's poss from Glo Domonsoro Sdn Bhd Operolion & Securly ol fhe designofed loading bay.

APPROVED/ NOT APPROVED

(Signoture, Dote & Stomp)
Operoilons Execufive

*Exfension of Penrl,il To Work should be opplied before lhe expiry dote