GCC –NIGHT SHIFT WORK PERMIT

STOP! Before starting night shift work activities, review all safety precautions.
Night shift permit must be made after meeting EHS requirements: Night shift permit will cover from
08:00 PM to 5:00 AM!

Project: Date of issue: Permit number:

General Construction Company: Sub- contractor: (Name)

Description of Work

EMERGECNY CONTACT NUMBER

(In case of any emergency please call ):

Required precaution checklist YES NO N/A

1. Responsible engineer need to be available on site with authority of decision making ☐ ☐ ☐

2. Night shift risk assessment is prepared and available at site. ☐ ☐ ☐
3. Method statement are available at night shift activities. ☐ ☐ ☐
4. Emergency procedures are established and implemented for the night shift activities. ☐ ☐ ☐
5. Full time EHS Officer is available. ☐ ☐ ☐
6. All work area are fitted with adequate lights with backup-power ☐ ☐ ☐
7. Full time first aiders & fire fighters are available for night shift activities. ☐ ☐ ☐
8. All the workforce undergo safety induction ☐ ☐ ☐
9. All the workforce undergo nightshift toolbox meeting. ☐ ☐ ☐
10. All mandatory PPE available. ☐ ☐ ☐
1. Night shift work Performer representative Acknowledgement: (Permit receiver)
We undertake to carry out the night shift activities in accordance with DM & GCC Safety standards & procedures. We are aware that we are
liable for financial penalties/warning letters for failing to carry out works in accordance to the DM EHS regulation & standards. We are also
aware that in the event of GCC EHS issuing stop work orders or prohibition notice we are bound to stop the work immediately.
Name & Signature:
(Sub contrator representative)

2. Checked and approved by Acknowledgement: 3. EHS Department Acknowledgement:

Authorization is hereby granted for the works as described above. I have checked above control measures and the work area is safe to carry out the activity.
Concerned Engineer Name: SAFE TO WORK UNSAFE TO WORK
(Permit Issuer) Signature: Safety officer Name:
Permit Validity Period (Time): From: To: Signature:
4. Closed Out:
This is to certify that the works described above have been safely completed / stopped / area has been restored to a safe and orderly condition.
Name: Name:
Concerned Engineer
Signature: Safety officer
(Permit Issuer) Signature:
Closed Out Time:

GCC-EHSF/ WNSP/Rev.04_03032022