WORKING PERMIT JIN HENG SHENG

PERMIT NO.: PERMIT DATE: DECEMBER , 2024

IMPORTANT NOTES:
1. Verify precaution listed at or DO NOT PROCEED with work.
2. Fire watcher must handle at ready a fire extinguisher unit.
3. This permit is valid for one job only.
4. If job requires work at height, a separate work at height permit must be obtained.
WORK TO BE DONE (PLEASE BE SPECIFIC): SPECIFIC LOCATION OF WORK:
WATERLINE PIPE INSTALLATION
TIME AND DATE WORK WILL BE DONE: DURATION OF WORK: WORKING HEIGHT:
DEC. , 2024 *7:00 to 24:00* _1__ Days __15___ Hours _0_ Min Min: __4____ m Max: __6____ m
PART I – REQUIRED PRECAUTION CHECKLIST PART II – CHAIN OF APPROVAL AND DOCUMENT CUSTODY
Has the equipment to be: Y N N/A PERMIT REQUESTED BY:
Depressurized X
Drained X NAME: CHEN, MIAO ID NO.:___________
Isolated by spading X
Water flushed X
Ventilated X SIGNATURE: DATE:DEC. , 2024
Purged with inert gas/steam X
Are sewer drain properly secured X IMMEDIATE SUPERVISOR/FOREMAN:
Is site clear from combustible (10m radius) X
Is Fire Protection required X NAME ABDULMAJID POLI ID NO.:__________
Is Fire Watch required X
Is Gas Tester required X
Specify how often gas tester is required X SIGNATURE: DATE: DEC. , 2024

INDIVIDUAL PROTECTION EQUIPMENT: RECOMMENDING APPROVAL

 Helmet  Safety Belts SITE ENGINEER OR PROJECT ENGINEER:
 Welder’s Helmet  Gas Mask
 Welder’s Apron  Safety Shoes NAME: LI GONG ID NO.:
 Work Clothes  Anti-Dust Coveralls
 Dust Mask  Dielectric Boots
 Hearing Protection  Dielectric Gloves SIGNATURE: DATE: DEC. , 2024
 Emergency Respirator  Rubber Safety Boots
 Protective Goggles  Welder’s Breeches I certify that the above location has been inspected, the Pre-Work
 Safety Harness  H2S Mask Inspection Checklist has been completed and the Special Precautions
 Safety Gloves  Double Safety Harness indicated have been taken.
 Safety Glasses  Others__________________ FIRE WATCH:
GAS ANALYSIS TEST DATE TIME DATE TIME DATE TIME NAME: IBRAHIM E. SALEH ID NO.:
Combustible
Toxic H2S
O2 SIGNATURE: DATE: DEC. , 2024
FIRE WATCH/HOT WORK AREA MONITORING
 Fire watch will be provided during and for 30 minutes after work, APPROVED BY:
including any coffee or meal breaks. CONSTRUCTION MANAGER AND/OR SAFETY & SECURITY LEAD:
 Fire watch is supplied with suitable extinguishers and is trained in NAME: RONNIELLE FADERA II / TCKI CMG ID NO.: ____________
the use of this equipment and in sounding the alarm. FOR:
SIGNATURE: ______________________________ DATE: 12 / / 24

SIGN OFF (30 MINUTES AFTER HOT WORK)

I certify that the above hot work has been accomplished, the area
thoroughly cooled down and cleaned up.
SAFETY OFFICER:
NAME:________________________________________ TIME: ________

SIGNATURE: ___________________________________ DATE: ________

REQUIREMENTS WITHIN 35FT (10M) OF WORK OTHER PRECAUTIONS TO BE TAKEN INTO CONSIDERATION
 Construction is non-combustible and without combustible  CONFINED SPACE ENTRY PERMIT must be secured if necessary.
covering installation.  WORK AT HEIGHTS PERMIT must be secured when working on
 Combustibles on other side of wall moved away. heights.
 Danger exists by conduction of heat into other areas.  Hot work area is protected with smoke or heat detection.
 Enclosed equipment cleaned of all combustibles.  Complete personal protective welding equipment.