Method Statement Corresponding Permit to Work No.

F P289-00-3795976

The Permit Issuer, when developing the respective Permit forms, will use the Method Statement supplied.

Company: Naseem & Son Project: Mobilization and Hard Date: 14/04/2022
Barrication around Tank SKP-06

1. Description of works
What the work entails?
Mobilization and Hard Barrication around Tank SKP-06
How is it going to be completed? Summarise the operation
Mobilization and Hard Barricade around Tank SKP-06

I. Site Induction
II. Mobilization of Material and manpower to site
III. Stacking of Material on racks.
IV. Hard Barrication around SKP-06
V. Housekeeping
Where is the work going to be completed? (Summary – more details on section 5)
See detail in section 5
Duration of the work? (Stating any times when access to the Terminal will not be required.)
25 Days.
Include site location drawings if appropriate?
NA
Are there any restrictions e.g. overhead power lines?
Nil
Are local permits required (Local regulations)?
Yes
Any other details
NA

2. Names of Responsible persons

Who is going to be working on the project?
Sagar Sharma
Sheraz Ahmed
Who will be in charge?
Sheraz Ahmed
Who has specific responsibilities? e.g. Plant, personnel, materials, etc.
Sheraz Ahmed ,MTehseen Khan
Who is to make contact with local authorities?
Sheraz Ahmed
Any other details

3. Plant and Equipment

What plant equipment and tools are required to do the job?

 Tools Wheel barrow, scaffolding pipes ,scaffolding joints and other general hand Tools

 Scaffolding
Yes
 Loading of materials
Nil
 Others, specify
Yes( GI sheets, Fire Extingusher, water cooler etc)

Form F – Method of Statement Distribution Permit to Work

Version 3.0 May 2007 Page 1 of 2
Procedure System
What certificates, if any, are required for plant or equipment?

What training, if any, is required for operatives?

Safety Orientation

4. Communications with the workforce

How are the procedures, hazards to be communicated to the workforce ?

 After getting desired work permits, a group communication meeting shall be conducted to
convey the action plan in case of any change in condition, like bad weather (rain/ storm etc) or
any change in plant/process area in the form of fire, leak of gas/oil/water etc. and also in case
of fire alarm/hooter

 In case of any emergency and where alarm goes on, all personnel must be evacuated
immediately from the work place and must be report to muster point. Extreme care should be
considered to avoid any unlikely injury caused by panic
 In case of any injury occurred then rescue team shell be called up at the scene with all safety
precautions and take out the injured person using the stretcher and shift him at safe place to
provide him first aid or in case of severe injury the team should rush to nearest
hospital/medical centre
 The incident shall be reported verbely to permit issuer and later incident report shall be
prepared and submit to client accordingly

Toolbox talks, safety meetings etc.

Toolbox meeting at the start of work regarding safe work.
Include records of any such meetings and record attendance.
Yes, toolbox form shall be filled on daily basis.
Other, specify.
PROPER HOUSE KEEPING.

5. How will the work be completed, i.e. Procedure step by step

Proposed Start date
11/04/2022
Step 1 : Mobilization of Tools, Equipment and Manpower to Site.
Site induction by terminal
Entry inside Terminal
Equipment and tool will be mobilized at site according to requirement by
using truck
Visual inspection of tools and equipment.
All the Equipment shall be third party certified.
Trained and competent resources must be deployed.
Step 2 : Stacking Of Material
Material will be Stacked manually following LITE formula
with manpower
Rack will be prepared for proper stacking of material
Material will be segregated such as joints, planks, scaffolding
pipes, GI sheets, Wheel barrow, gas cutter and other hand tools
will be stacked properly
Do not lift, lower, push, pull, or carry a load greater than 25 kg.
Use correct posture and lifting technique
Wear appropriate hand protection suitable for task
Ensure PPEs suitable for task
 Step 3: Hard Baricade Area around SKP-06
Clean the working area
Erect Scaffolding pipes for GI sheets on base
plate
GI sheets will install on Scaffolding
Tank SKP-06 will be hard barricade from all
foursides
Walkways for operation working will not disturbed
Wear appropriate hand protection suitable for task
Flogging spanners are prohibited from use
The use of knives is prohibited
Inspection should be done before use
Always keep clean.
Never take shortcuts.
Never use damage tools and equipments
Step 4: Housekeeping.
Housekeeping of the working area will be done during and after job.

Form F – Method of Statement Distribution Permit to Work

Version 3.0 May 2007 Page 2 of 2
Procedure System