Form No.
- DME/001
To, Date: __________
The Head of Department,
Mechanical Engineering, SFIT, Borivali West.
Subject: Permission to use _______________________________ laboratory (lab no.: ________).
Respected Sir,
Description of Work:
For issuing tools/components
Issue Return
SN Details of Tools/ Components
Date & Time Date & Time
For using machine/system
SN Machine/System Date In Time Out Time
I hereby declare that I have read and understood the safety instructions and shall carry out my work
in a safety conscious environment in compliance with all regulations as laid down by the SFIT as
well as verbal instructions.
In the event of an accident which is due to my negligence and/or non-compliance with SFIT safety
regulations and procedures, I will indemnify the SFIT on all liabilities.
I will ensure that the working space and equipment in the laboratory are clean, tidy and in orderly.
SN Name Branch PID No. Roll No. Contact No. Signature
Name & Signature of Project Guide
(Kindly take signature of respective subject in-charge/class coordinator for course project/any other work)