Section Health, Safety and Security

Status Controlled Copy

Electrical Work Permit Reference
Revision
Sheet

(REPAIR / INSPECTION / CLEANING / MAINTENANCE WORKS FOR ELECTRICAL EQUIPMENT / SYSTEM)

Work should not commence until stages 1 to 4 are duly completed.

Part 1: APPLICATION
Company Names of Workers Involved Date / Time

Name of Contractor’s
Authorized Person:

Location

Description of Work:

Part 2: ENDORSEMENT
Contractor’s Authorized Person Confirmation of Lock-out Practices Tick
1. I have referred to the electrical 1. All electrical points had been isolated and earthed.
installation layout plan. 2. All isolated points have been securely lock-out by Main Contractor &
2. I have identified the electrical points Contractors authorized person.
to be isolated, locked-out and tag-out. 3. All isolated points had been displayed with Danger! Do not Operate!
3. I have briefed all personnel involved MEP Contractors authorized person.
in the work on the Lock-out Procedure. 4. All locks are in good working conditions.
Name 5. All workmen worn required PPEs.
Designation 6. I have briefed all the workmen.
Signature Date 7. Other Safety checks / instructions.

Part 3: ENDORSEMENT BY AUTHORIZED Part 4: ACCEPTANCE AND CONFIRMATION BY MEP

PERSON/ CONSULTANT CONTRACTOR’S AUTHORIZED PERSON
1. I understand the nature of work and the safety measures to
The above work is APPROVED / NOT APPROVED. be taken and confirmed that all steps of procedure (overleaf -
before work commences) are carried out.

2. I agree and accept the conditions and shall stop work

immediately should any of the conditions changes.

3. I have brief all the workmen.

Signature Date/Time Signature Date/Time

(Main Contractor / Authorized Person) (MEP Contractor / Authorized Person)

PART 5: PERMIT CLOSE OFF

I, (Name of MEP contractor’s authorized person) informed that all

works have been completed on (Date) and (Time).

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 Section Health, Safety and Security
Status Controlled Copy
Electrical Work Permit Reference
Revision
Sheet

PART 6: PROCEDURE BRIEFING

This procedure is as follows:

Before Works / Repairs Commences

 MEP contractor involves in the work / repairs / inspection / cleaning / maintenance on electrical equipment / system / machinery /
plant apply for permit to work from Main contractor’s authorized person.
 MEP contactor’s authorized person with the assistance of the Main contractor’s electrical department isolate and earthed all power
points connected to the electrical equipment / system.
 MEP contractor authorized person removes all ‘Equipment Alive Tag’, lock-out and display Danger! Do not operate! Tags out all
isolated points.
 MEP contactor’s authorized person lock-out and display ‘Danger! Do not operate’ tags at all isolated points over the Main contractor’s
authorized person’s safety tags.
 MEP contractor’s authorized person trained all personnel involved in the works / repairs / inspection / cleaning / maintenance.
After Works / Repairs
 MEP contractor’s authorized person through permit to work that all works / repairs / inspection / cleaning / maintenance completed.
 MEP contractor’s authorized person informs all personnel involved to confirm on the completion of works / repairs / inspection /
cleaning / maintenance.
 MEP contractors authorized person remove all their locks and tags and inform Main contractor.
 MEP contractor authorized person with the assistance of the electrical department re-energize all power points to the electrical
equipment / system / machinery / plant and display the ‘Equipment Alive Tag’.

The keys to all locks shall only be held by the main contractor’s authorized person and works / repairs / inspection / cleaning / maintenance
performing MEP contractor’s authorized person.

The lock out method by authorized persons shall be in such a manner that no other person can energize the electrical equipment / system /
machinery / plant unless the lock is removed.

EMERGENCY RESPONSE BRIEFING

In case of fire:
 Fight fire if possible and safe to do so.
 Report to supervisor in-charge or if he is not present through the emergency intercom immediately.
 Remove all flammable materials which can spread the fire.
 Switch all machinery and electrical supplies.
 Evacuate and assembly at the muster point.

In case of casualty:
 Do not touch victim unless you are sure that you will not be electrocuted.
 Perform CPR if you are trained and it is safe to do so.
 Keep victim attended at all times.
 Report to the supervisor in-charge or through emergency intercom if he is not present immediately.
 Clear all obstructions for effective emergency team access.
 Barricade incident area.

S/No. Name Signature S/No. Name Signature S/No. Name Signature

1. 1. 1.
2. 2. 2.
3. 3. 3.
4. 4. 4.
5. 5. 5.

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