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CSEC No. 號碼 001

CONFINED SPACE
Mabar Power Station SAFE ENTRY CERTIFICATE
侷限空間作業許可證

1.本許可證發給予 Certificate issued to：發給: Andrew Wong 所屬部門 Department：Mechanical Maintenance Section
2.侷限空間地點 Details of Confined Space，地點 Location：Unit 1 Turbine Basement Sump Pit
3.在測試侷限空間內之氣體之前，工程作業負責人員必須確認已持有有效之工作許可證 PTW/LWC，其內容為：
Before testing the gas inside the confined space, Maintenance personal responsible for work in the confine space must confirm
that a valid permit to work has been issued. The details are：Unit 1 Turbine Basement Sump Pit concrete repair
3.1 相關安全文件編號 Associated Safety Document No.： PTW 003
3.2 工作概略 Work to be carried out： Concrete repair
4. Type ＆ Model of equipment 氣體檢測儀器種類和型號： Microclip XP Gas Detector
5. Results of Confined Space Air Testing 侷限空間內氣體測試結果：
測定氣體項目 Items of Gas Tested
測定日期/時間 測定位置
Combus- 運轉處侷限空間作 有效時間 特別安全規
Date/Time of Test 氧氣 CO H2S
tible Gas 業主管簽名 Date/Time 定/器材
est Location Ｏ２﹪ ppm ppm
﹪
1 8/6/2015 - 5m 21 0 0 0 Alex Lo 8/6/2014, Instruction for
@ 0915 - 3m 21 0 0 0 2359 hrs working in a
hrs - 1m confined space
21 0 0 0
2

10

6. 本人茲聲明：倘若遵照此證內之條件及特別安全措施及電廠安全守則規定，此侷限空間可以安全進入及進行所述之工
作，但每次檢測有效期最長為 24 小時。I hereby declare that the above Confined Space is safe to enter to conduct the work as
stated, provided that all conditions and precautions of this certificate, and the requirements of the Mabar Power Station Safety
Rules, and the Confined Space safe entry procedure are observed, but Air Testing only valid for 24 hours each time.

7. Receipt 接受
I hereby declare that work by myself, or by any person under my control, in the above Confined Space shall
be carried out in accordance with the conditions of this certificate and the requirements of the Mabar Power
Station Safety Rules.
茲聲明： 本人或本人屬下任何人在上述密閉場地內工作，將遵照此證所載之條件及電廠安全守則。

Signed 簽署: Andrew Wong Being a Competent Person (Confined Space)

為幹練人員(侷限空間)

Time 時間: 0920 hrs Date 日期: 8/6/2015

8. Clearance 撤離
I hereby declare that all persons under my charge have been withdrawn and warned that it is no longer safe
to work in the above Confined Space and that all gear, tools and other equipment have been removed.
茲聲明：本人屬下之所有人員經已撤離上述密閉場地並已警告該處不再安全，全部裝置、工具及其他器械亦已移去。

Signed 簽署: Andrew Wong Being a Competent Person (Confined Space)

為幹練人員(侷限空間)

Time 時間: 2230 hrs Date 日期: 8/6/2015

9. Cancellation 註銷

I acknowledge receipt of the clearance of this certificate. 本人已收到人員已撤離該密閉場地之通告。

This Certificate is now cancelled. 現將此證註銷

Signed 簽署: Alex Lo Being An Authorised Person

為授權人員

Time 時間: 2235 hrs Date 日期: 8/6/2015