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Work Order#:
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ENGRO FOODS LTD
engro foods
HOT WQBK PERMIT
Read Instruction a 0 n the back of the C■rd Copy

······· ········.. ., .... ., ... ,,.,, •······........ ,................. ...... ~ ......... _, ..........,..,, _..........
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NOTE: In the following tick ( ✓ ) whichever Is applicable. YES NA NO

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□ Pt □
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D □ G1
SPECIAL PROTECTIVE EQUIPMENT REQUIRED
D Full Face Mask ~ Goggles D Safety Harness

D Fresh Air Mask D Acid Proof Pent & Coal D Rubber Shoes
D Face Shield , [i21- Safety Shoes D Rubber Gloves
D Scott Air Pak Safety Helmet None [~::r
Others (specify) _ _ __ _ _ _ _ __ _ _ _ __ _ __ .......,,.,....._
D
❖ Name of person assigned lo check operating conditions? ~-, ~\"'W''li \\\.'" .~ J \..
❖ Special Instructions:

INITIATED BY: Co-Signed By AUTHORIZED BY:

Team Leader Farm Manaer Area Manaer

For Lhe CurdnQ Only

Job handed over after complete preparations. YES NA NO

+ Installed a red lock number
DD □
Eleclrical

Area Operator
I understand the precauUons lo be taken lo perform this job, YES NA NO
+ I have ensured that the circuit is de-energized.
- □□ □
♦ I have installed my personal lock on Ille breaker. DO D
+ I have ensured that all other locks are in place. DO D
+ My lock number is
Electrical

Malnlenance Per1on

Extended upto Hours on ._ _ _ _ _ 20 _ _ _· By _ _ _ _

APMIAEM

Name cit Incoming Alea Operator..' -_ _ _ _ _ _ _ __

Slgna1ure of Incoming Operator

Name of Incoming
Maintenance Person:
-------- ----,--
Incoming Maintenance
Person's lock numbei:
Electrical Signature of Incoming
Maintenance Person
Job completed. D Time:__._ _ _ _ _ _ Hours
Job incomplete. D Dale: _ _ __ __ 20
YES NA NO
+ All plu11s / caps removed earlier have been re-lnstallecl. DOD
♦ I have removed my personal lock . DOD
Maintenance Person
♦ I have Inspected the equipment at the worksile oncl have lllken over
after completion and housekeeping.

Smoking II pn,hlblllld In 111 Wolll Parmlt aroa1, GWJpt 1111 dulgnllad

Area Operator I Toam Loader
placet.