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PERMIT TO WORK SAFE

Authorization to Work: AtW20240402836 Print Date:19-04-2024

Client:HSBC Country-Territory:Sri Lanka In-country-Territory Region:Sri Lanka

Property: Kandy, Cross St

Task Location : KDY

Brief Title for AtW: Adding of chemical to the cooling tower

Duration of work (Hrs) & Time Zone: 36 GMT+05:30

Start Date: 20-04-2024 Start Time: 09:00

Completion Date: 21-04-2024 Completion Time : 21:00

Description of Work ** Isolation of Cooling Tower Clean the infills by high pressure water jet. Clean the basin
PLEASE IDENTIFY ANY using high pressure water jet. Remove the debris and waste in the basin . Add
HIGH RISK WORK **: chemicals after cleaning.

Potential Impact to Client: None

Potential Impact To Plant /

None
Equipment / People:

Special Instructions And

Adhere to WMS
Comments:

Type of Work ** All work

impacting Critical
Spaces/Services or works
including High Risk Planned Maintenance - May Require a PtW
activities must have an
AtW, PtW and Method
Statement. **:

Supplier Name: Wasser Kraft Tech Lanka (Pvt) Limited

Site Supervisor Name: Nimal Jayarathne

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Site Supervisor Contact
0777042745
Number:

Emergency Contact
Shaman
Name:

Emergency Contact No: 077 500 7223

Schedule of Site Workers for this Authorization to Work

Worker Grade and

Ref. Name of Expiry
License/Registration/Identification Trade Registration Qualification
No. Worker Date
No No

J.W.Maneesha Service
1
Bhashini Engineer

Roshan Service
2 198511304972
Senevirathne Engineer

R. Supun
3 198920101605 Dileepa Technician
Rajapaksha

Nimal
4 692602838V Technician
Jayarathne

Aruna
5 741142198V Technician
Priyadarshana

Chandika
6 772251530V Technician
Botheju

D.V.Sampath
7 891882483V technician
Samarasinghe

Workflow for Approval of Authorization to Work

Approval Level Category:

Approval Level Category Approver Name Date Approval Status Comment

Site FM/Engineer Chamika.Liyanage / Dileepa.Udumalagala Waiting For Approval

WAT.pdf Method Statement 88646 2024-04-19 Uploaded

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