ArcelorMittal Nippon Steel India Limited (AMNSIL)

Permit to Work
Doc. Number: AMNSIL /SAFE/01/SOP

Address:
PLANT SITE

ArcelorMittal Nippon Steel India Limited (AMNSIL)

27th KM, Surat Hazira Road, Hazira 394 270
Dist. Surat, Gujarat.

Tel:(+91 261) 6682400

THIS PERMIT TO WORK DOCUMENT IS THE PROPERTY OF ARCELORMITTAL NIPPON STEEL INDIA LIMITED.
NO PART OF THIS MANUAL IN ANY FORM MAY BE PRINTED OR REPRODUCED WITHOUT PERMISSION FROM PLANT
CHIEF. ALL ENQUIRIES REGARDING THIS MANUAL MAY BE DIRECTED AT THE ABOVE PLANT ADDRESS TO
MANAGEMENT REPRESENTATIVE WHO IS RESPONSIBLE FOR ITS ADMINISTRATION.

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 • Permit to Work

Section No. 0.1

DISTRIBUTION SHEET

DOCUMENT NUMBER : AMNSIL /SAFE/01/SOP

REVISION NUMBER : 01

EFFECTIVE FROM : 01.09.2022

CONTROLLED COPY NUMBER :

(Applicable only if it is controlled copy)

Doc Number: AMNSIL/ Revision :01 Effective from: Page 2 of 59

SAFETY/01/SOP 01-09-2022

Prepared By Reviewed By Approved By

HSE - AM/NS India, Hazira Head Operations, Hazira Executive Director- AM/NS India

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 • Permit to Work

Deliberations to simplify the “Permit to Work standard was held with the following committee
members.

Sn. Name Department Signature

01 Manish Khanna CMD

02 Subir Kumar Central Services Electrical

03 Arvind Sinha Sinter

04 Girish Bannithaya Corex

05 Jignesh Shah SMP-1

06 Jayesh Modi HBI

07 Satyam Jain Pipe Mill

08 Vijay V Gajjar 500MW

09 Dharmraj Desai Material Handling

10 R K Verma CSP Mill

11 Sagar Upasane HSM

12 Ajay Singh SMP-2

13 Santosh Mishra SMP-2

14 Praksh Hegde Blast Furnce

15 Shrinath Padubidri Platemill

16 Lohit M CHSE

17 Amrinder Singh Projects

18 Nirav Gajjar SMP-1

19 Prakash Patel Corex

20 Shubham Chaudhary CHSE

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DOCUMENT ISSUE

The Standards for Permit to Work issued by the Central Safety Committee on behalf of AMNS India
management and form a part of the HSE management system.

Name: Santosh Mundhada

Executive Director
Sd/- 01.09.22

Date of Release:

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 • Permit to Work

This document contains proprietary and confidential information of AMNS India and is intended solely
for the internal use of authorised personnel. This should be treated as BUSINESS CONFIDENTIAL and
its external use or disclosure, unless specifically authorised, is strictly prohibited.
Abbreviations
• AM/NS INDIA – ArcelorMittal Nippon Steel India Limited
• HSE –Health, Safety and Environment
• IMS – Integrated Management System
• PPE - Personal Protective Equipment
• PTW - Permit to Work
• LOTO - Lock out / Tag out (Energy Isolation)
• WAH - Work at Height
• LEL - Lower explosive limit
• HR - Human Resources
• FA - First Aid
• MT- Medical Treatment
• RW - Restricted Workday
• LW - Lost Workday

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 • Permit to Work

Table of Contents

1. Introduction: .........................................................................................................................9
2. Purpose ...............................................................................................................................9
3. Scope of application .............................................................................................................9
4. Applicablity For Work Permit: ............................................................................................. 10
5. References ......................................................................................................................... 11
6. Management Responsibilities ............................................................................................ 12
7. Definitions .......................................................................................................................... 12
8. Standard/Guidelines ........................................................................................................... 14
10. Management Systems ...................................................................................................... 36
11. Appendix .......................................................................................................................... 37

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Permit Standard Procedure:

1. What is PTW?
Permit to work is a written document used to authorize job that could expose workers to safety and health
hazards. It identifies the work to be done, the hazards involved and necessary preparation and
precautions for doing the job safely.

2. When PTW is required

• PTW is required to be taken for all non-routine activities.
• Hot work permit has to be taken for activity involving source of ignition that could cause a fire or
explosion.
• Cold work permit has to be taken for those activities which do not produce spark or sufficient heat to
ignite a flammable or combustible material. HOD may release list of routine activities exposed to lesser
hazards, where PTW is not required.

3. Procedure to Issue and Authorize PTW Format

Step 1 - Part A (Application and Work Description) will be filled and signed by Permit Applicant.
Shutdown Authorizer will sign it to confirm the plan to do that job.
Step 2 - Part B (Safety Measures Taken + PPE + Fire Precautions + AMNS INDIA Standard Certificates
Required) to be filled and signed by Permit Applicant as per requirement of job or as mentioned in SOP
for that mentioned job. The Permit Applicant will obtain required certificates for the job.
Step 3 – Permit Authorizer will visit the site for Risk Assessment and will cross check the certificates
based on the required precautions fulfilled at the site and will ensure TBT conducted. Also, will see the
Risk Assessment(HIRAC/TBRA) references are matching on PTW. Permit Authorizer can change PTW
Requirements depending upon the site requirements.
Step 4 – After completion of Step 1 to 3, Permit Applicant along with Permit Holder and Permit
Authorizer will sign the Part C.
Step 5 –. Toolbox Talk will be conducted by Permit Applicant with team members in the presence of the
Permit Holder and points mentioned in Risk Assessment & SOP will be shared.

4. Procedure to Display of Permit-To-Work (PTW)

• Green Copy of PTW shall be displayed on the site so the persons who need to be aware or to refer are
able to do so.
• Pink Copy will be retained with Permit Holder if Applicant has signed more than one PTW, having
ensured that the working party members are familiar with its content and control measures.
• White copy should be with authorizer, where these should be displayed in a systematic arrangement.

5. Procedure to Close PTW after job completion

Step 1 - After completion of the job, Permit Holder shall ensure housekeeping of the area is done.
Step 2 - Permit Holder will ensure that deployed manpower for the job is taken out along with tools and
tackles.
Step 3 - Permit authorizer will inspect the site after completion of job and get the permit signed by Permit
Holder, Applicant and Himself.
Step 4 - Permit Applicant will then ensure closure of all certificates issues if any for the job.

6. Procedure for PTW Extension

If the job is not completed by end of the shift, then work shall be stopped at the end of the shift. The work
can be resumed only when the PTW validity is properly extended by the authorizer by signing who will be
present during the extension period after performing TBT again if the executing team is changed. In case
of critical activities, the authorizer can extend the PTW at site, before the expiry time of PTW to avoid

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stoppage of work. e.g. in case of person WAH need not to come down just for the sake of extension of
permit.

7. Cancellation of PTW
In the event of any of the following circumstances occurring during the course of an activity under permit,
the Permit Holder must stop the work and communicate Applicant/Authorizer to cancel the PTW

• The specified equipment or tools to be used not being available.

• Any changes in the type and nature of work.
• Occurrence of any condition / situation during the progress of the work that was not anticipated.
• Any change in the process condition or the surrounding. (E.g. unexpected release of gas from a nearby
tank).
• An emergency in the area.
• Any change in the weather condition.

8.Procedure to keep the records

Filled Permit-To-Work (PTW) Retention Period: Six months

Record of Tool-Box-Talk (TBT) Retention Period: Six months

9. Review Procedure
Review of this procedure shall be done as and when but not later than once in every two years. Typical
Factors like Changes in legislation, Review of Incident Reports, Inspection & Audit findings, Feedback
from users, Recommendations in Incident investigation reports may be inputs for the review and revision
of the procedure.

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1. Introduction:

A Permit to Work is a written document used to authorise jobs that could expose workers to safety and/or
health hazards. It identifies the work to be done, the hazards involved and the necessary preparation
and precautions for doing the job safely. It also serves as a checklist to ensure that all hazards,
protective measures, work procedures and safety requirements are reviewed with and understood by the
supervisor and the assigned workers.

2. Purpose

The objective of a Permit to Work is to formally establish safe working conditions for carrying out
potentially hazardous jobs. The Permit to Work serves as a record of the authorisation, the description
and the completion of specific work. The authorisation must be provided by a competent person after
ALL the necessary conditions have been met. The Permit to Work is also the acknowledgement that the
specified work has been discussed with the job supervisor and/or the workers doing the job. The Permit
to Work document is the formal agreement to follow the indicated procedures and precautions.

3. Scope of application

This Standard is applicable to AM/NS India. It describes the principles used to protect employees and
contractors from potential hazards while working within the premises.

a. There shall be an approved list of employees & associates who are Permit Applicant, Holder &
Authoriser by respective Plant HOD. They will be trained and assessed by their respective HOD &
Safety Managers.

b. This approved list will be updated periodically every twelve months based on attrition, promotion,
transfers, etc.

c. A Permit to Work (PTW) shall be used whenever work could expose workers to the danger of fire;
sparks or open flames due to welding, grinding, furnaces or torch cutting; flammable/explosive gases;
toxic substances or atmospheres; extreme pressure; burns from steam, hot surfaces or materials at
extreme temperatures; dangerous energy sources, such as, electricity, chemicals, mechanical,
hydraulic or pneumatic; atmospheres that are oxygen deficient or oxygen enriched; potential for
suffocation, drowning, being struck by an object or engulfment by materials; potential for crushing by
ingress of materials or cave in of trenches or pits; and/or potential over exposure to ionizing radiation
or radioactive substances.

d. A list of critical activities to be prepared by each department which require sign off by respective
HOD.

e. Relevant safety mandate must be complied during the execution of the job.

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f. The Work Permit is a legal document so no over writing and cutting is acceptable; hence all the
conditions and instructions mentioned in the Work Permit must be adhere to.

g. Work carried out in tools/rooms/ workshops (like electrical/ mechanical/ housekeeping) considered as
non-routine jobs and require Work Permit.

4. APPLICABLITY FOR WORK PERMIT:

Normally all maintenance, repair, construction work shall be carried out with a proper work permit.
Jobs where work permit is required include but not limited to followings:

• Major and minor maintenance work

• Inspection

• Construction **

• Alteration

• Any hot work (including use of normal battery driven equipment in operating areas)

• Cleaning activities of process equipment

• Entry into confined space

• Excavation

• On any gas line & equipment

• Work at height / roof

• Handling of materials using mechanized means in operating areas

• Erection and dismantling of scaffold

• Radiography

• Isolation and energisation of electric / mechanical equipment/ facilities

• Chimney Work

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Works exempted / partially exempted from Requirement of Permit:

• Routine work carried out by operations Dept. personnel (e.g. pump change over, furnace lighting,
operating valves, inspection, testing & maintenance of fire safety equipment etc.). It is considered that
safety measures are built-in in system while carrying out above works and covered in Operating manuals.

• Routine work carried out on equipment taken into workshop and defined repair area by
maintenance dept. and routine operation of workshop equipment. This job must be carried out with
relevant SOP & HIRAC and safety mandate.

• Routine testing of samples and handling chemicals in Quality Control Laboratory (except hot work
permit).

• Jobs carried out during emergencies (fire/ explosion, rescue, uncontrolled release of hazardous
chemicals etc.) to control the emergency.

• Work carried out at construction site with management approval (except permit for hot work,
excavation, radiography and working at height).

• Work carried out in Breakdown can also be considered when method statement/protocol along
with JSA & HIRAC is available. Also, it should fulfill all the conditions mentioned in work permit and those
who are engage in that job should be aware of associated hazards & mitigation plan. Method statement/
Protocol should be duly signed by Plant Head or HOD.

** Construction:

• If the project area is inside the plant working premises and the area is handed over by the plant
head to the project department through protocol with signoff all other service department and the project
area should separate through hard barricading, then concerned project manager/ in charge is responsible
for effective implementation of permit to work system. Any other persons apart from projects can enter by
taking prior approval/permission of site in charge. Entry/ Exit register should be maintained.

• For brown field projects, Project/site in charge will be the responsible for effective implementation
of permit to work system.

5. References
▪ AM/NS INDIA IMS Policy
▪ AM/NS Health & Safety, Environment, Quality Policies.
▪ Oil India Safety Directorate (OISD-105)

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▪ Indian Factory’s Act 1948.

▪ Lock Out Tag Out (LOTO) (OSHA 29 CFR 1910.147)
▪ Electrical Safety Standard

Types of Permits [or Certificates]

Hot Work
Cold Work
Work at Height
Confined Space Entry
Excavations
Lock out / Tag out (Energy Isolation)
Hydra (pick & carry crane)
Lifts [or movement] of Heavy Equipment or Materials with Cranes or Hoists
Electrical Work
Use of Radioactive Materials
Road Closure
Gas line/ Equipment work
High Tension Line/ Equipment

6. Management Responsibilities

Line management has the responsibility to implement all aspects of this PTW standard.

7. Definitions

• Work permit— the written or printed document that is issued to establish safe working conditions
for workers involved in potentially hazardous jobs. The document specifies the work, the location
of the job, the time allowed for the work to occur, the potential hazards, as well as the precautions
and procedures to be followed while doing the job.
• Method Statement — A method statement is a document that describes how to do a task safely.
You can think of a method statement like a set of instructions or a plan for the work.
• Permit Holder — A person appointed by the Applicant to be in charge of one job. He is
responsible for ensuring that the group of workers at the job site strictly follows the safety
precautions and requirements mentioned in the Permit to Work or Certificate. Permit Holder may
be an AM/NS INDIA employee or Contractor supervisor/worker among the group of performing
job, having with at least 1-year of industrial experience. The Permit Holder must have attended a
training course on this Permit to Work Standard. Permit Holder must be appointed by respective
HOD’s through section heads of the department. He will be carrying permit copy and if he/she
observed any violations he/she is authorized to halt a job and he must bring to the notice of permit
applicant.
For a high-risk activities supervisor must be made as a holder. The Applicant may also serve as
the Permit Holder. However, if the Applicant becomes the Permit Holder, then he shall not be the
Applicant for any other job.

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• Permit Authorizer — A person who is authorized 1) to verify that all conditions for working safely
have been met, 2) to define ongoing precautions to maintain safe working conditions during the
work, 3) to authorize the work to occur, and 4) to cancel the permit. The Permit Authoriser must
have attended a training course on this Permit to Work Standard. The Permit Authoriser is
appointed by the Head of the Department. The Permit Authoriser must be a AM/NS INDIA
employee.

Note: Permit Authoriser has to personally visit the site to verify permit condition are met. In case
Authoriser is not able to personally visit the site, he should nominate in writing the authorised person
for site visit. Signature, Name & SAP ID of the Permit Authoriser shall be clearly mentioned on the
permit.

Permit Applicant – The person who applies for a Permit, or Certificate as necessary, and completes the
work described in the work permit and approved by the Permit Authorizer. He is responsible for ensuring
that a Permit Holder is appointed, and Permit Holder is present at all times when the work is under way.
If the Permit Applicant serves as the Permit Holder for one job, then he shall not be the Applicant for any
other job. The Permit Applicant must have attended a training course on this Permit to Work Standard.
The Permit Applicant must be a AM/NS INDIA employee with at least 2-year of industrial experience.
Permit Applicant must be approved by respective HOD’s. HOD’s may have discretionary power to
change the above-mentioned criteria for Permit Applicant based on the severity of the job and which
should be signed by Head Operation / Executive Director.

• Certification—a verification process, which documents that a person has the necessary training,
skill, and/or experience and the ability to perform designated roles and tasks.

• Working at Height — Elevated working positions where the risk of a fall from height exists and
where there is no physical protection, such as handrails, to prevent falls. Types of work covered
include working from all types of ladders, scaffolds, chimney, mechanical lifts, Cranes, Heavy
Earth Moving Equipment, inside confined spaces, sloped roofs, side sheeting, painting, areas
where there are no overhead tie-off points, when working within 1.8 meter of the edge of a flat
roof, erecting steel or installing/replacing roofing and in pipe racks. This does not include normal
work on low stepladders, loading platforms with fixed handrails, or similar locations.

• Cold work- All work, other than hot work, entry into confined space, excavation, heavy lifts,
working on electrical power distribution equipment, that does not specifically pose an unsafe
condition under normal conditions. It is an activity that does not generate enough heat or cause
sparks that could ignite a flammable substance.

• Confined Space – Includes reactors, columns, column skirts, vessels, pipe lines, storage tanks,
spheres, bullets, coolers, bins, silos, sumps, trenches, pits, sewers, furnaces, underground
service lines, boiler drums, condensers, flue ducts, HVAC ducts, false ceilings and floors, where
deficiency of oxygen (<19.5 %) or presence of toxic/flammable gases is likely and/or the space is
not designed for human occupancy in normal circumstances.

• Confined space entry - Entry of personnel into confined space, as described above, including
insertion of body parts, such as head, hands/arms, feet/legs, through the man-hole or other
openings.

• Lock out / Tag out (Energy Isolation) – Positive isolation of equipment connected to any source
of power; such as electricity, mechanical energy, chemicals, hydraulic, pneumatic or potential

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energy [because of elevation (gravity)]; for the purpose of performing work on the equipment or
inside the equipment.

• Excavation – means digging, road cutting, removing soil, chipping, grading and excavation work
which involves removal of earth to a depth of 30 cms or more, either using self-powered
mechanical equipment or manually digging [with a shovel, hoe, pick axe, etc.]

• Hot work –Includes any work which involves welding, burning, soldering, brazing, blasting, gas
cutting, grinding, chipping by spark-producing tools, use of certain power driven tools, non-flame
proof electrical equipment or machines with internal combustion engines and including any other
work which is likely to produce sufficient heat capable of igniting flammable gases.

• Restricted Areas – means enclosures for electrical transformers, high voltage electrical facilities,
pipe lines containing poisonous gas, electrical motor control cabinets, the space surrounding
electrical power lines, and equipment holding radioactive sources. It also includes any space or
enclosure that is clearly marked as a "Restricted Area - No unauthorised entry".

• Risk Assessment - A process used to assess the risk associated with any activity by identifying
the hazards and evaluating the control measures, before starting the job. For example: Hazard
Identification Risk Analysis (HIRA), Job Safety Analysis (JSA), etc.

• Cave-in - The separation of a mass of soil or rock material from the side of an excavation, or loss
of soil from under a trench shield or support system, and its sudden movement into the excavation
in quantity that it could entrap, bury, injure, or immobilize a person.

• Competent person (Excavation) - One who can identify existing or predictable hazards in the
surroundings that are unsanitary, hazardous, or dangerous to employees. He has authorization
or authority to take prompt corrective measures to eliminate them. He has the authority to stop
the excavation activity or any work inside an excavation pit or trench.

• Shoring (shoring system) A structure such as a hydraulic, mechanical, or timber shoring system
that supports the sides of an excavation and which is designed to prevent cave-ins.

• Sloping (sloping system) A method of protecting employees from cave-ins by excavating to

form sides of an excavation that are inclined away from the excavation so as to prevent cave-ins.
The angle of inclination required to prevent a cave-in varies with differences in such factors as the
soil type, environmental conditions of exposure, etc.

• Benching (benching system) - A method of protecting employees from cave-ins by excavating

the sides of an excavation to form one or a series of horizontal levels or steps, usually with
vertical or near-vertical surfaces between levels.

8. Standard/Guidelines

8.1. Types of Permits to Work (PTWs)

There are various types of PTW used to accomplish work at AM/NS INDIA. The following sections
describe them and the requirements of those types of PTW.

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8.1.1. Hot work permit

Hot work permit authorization has to be obtained prior to starting work involving the introduction of
a source of ignition that could start a fire or explosion.

8.1.1.1 Scope

A Hot Work Permit is required under following situations:

• Jobs that involve Welding, Cutting, Grinding, Brazing, Soldering, & Jack hammering.
• Use of any equipment or tools that could cause sparks that could ignite a fire.
• Use of open flames from torches or any other apparatus that produces an open flame.
• Using non-explosion proof, non-intrinsically safe electrical and/or
electronic equipment.
• Using compressors, generators, pumps, welding machines, etc. that have an internal
combustion engine for power.

8.1.1.2 Procedure

Permit Authoriser:

• The hot work permit shall be issued by a person authorised by the Head of the Department.

• The authoriser shall personally inspect the job location and ensure that the area is safe for
carrying out the work as requested by Maintenance/ Inspection/ Construction Applicant.

• The exact location, nature of job, item/equipment on which the work will be carried out, special
instructions, isolation requirements (if any), separate PTWs to be obtained, etc. shall be
mentioned in the permit, also, to avoid any ambiguity in the safe execution of the job. The Hot
Work PTW is valid for one shift.

• A hot work permit is issued in triplicate. The first copy shall be taken by the Permit Applicant
unless he appoints a Permit Holder. The first copy is passed to the Permit Holder and the
second copy shall be displayed at the job location to make other people aware of the job, fire
hazards, isolations, other precautions etc. The authoriser shall retain the third copy. The
authoriser confirms the 2nd copy is displayed. The Hot Work PTW extension should be done
after every shift.

• Separate certificates shall be issued for equipment isolation (LOTO), work at height, confined
space entry, etc., as required, before a hot work permit is issued for the actual job. Refer to
the relevant standard(s).

• The authoriser shall visually inspect the job location and vicinity (up to a radius of 10 meters)
to confirm the site is free from flammable materials (combustibles gases, liquids, dusts or
other solids). If flammable materials are present, then the authoriser shall not issue the hot
work permit. The authoriser shall use an explosimeter or portable flammable gas detector to
measure the atmosphere of the work site. Any reading or indication by the explosimeter other
than ZERO (0% LEL) shall confirm an unsafe condition and the authoriser shall not issue the
hot work permit.

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• If there are process sewer openings or drains within 10 meters of the site of the hot work, then
these openings or drains shall be completely covered by wet, fire proof blankets to prevent
any spark from entering the opening or drain.

• If the hot work shall be done at height from an elevated platform (>1.8 meters), then a
separate Work at Height Certificate must be obtained first and the area below the hot work,
where it is possible for a spark or welding slag to fall, shall be properly barricaded to prevent
pedestrians from walking beneath the hot work job. The authoriser shall ensure the applicant
or supervisor shall direct his subordinates executing the hot work to contain all sparks and/or
hot slag. Other work beneath the elevated hot work shall not be allowed at any time. These
requirements must be mentioned in the Hot Work Permit. The Work at Height Certificate must
be mentioned in the Hot Work Permit.

• If the hot work shall be conducted inside a confined space, then the authoriser shall confirm
the Confined Space Entry Certificate is obtained first by the applicant for the hot work. The
authoriser shall indicate clearly on the permit document that the hot work shall be conducted
inside a confined space and list the reference to that certificate on the hot work permit. Refer
to the definition of a confined space. Follow the pertinent sections of the Confined Space
Entry Standard.

• If the hot work shall be conducted inside a confined space, then the atmosphere in the
confined space shall be measured to confirm it is not oxygen enriched. The portable oxygen
meter must indicate the oxygen concentration is 19.5 – 23.5%. If the oxygen concentration is
23.5% or above, then the authoriser shall not issue the hot work permit.

• The results of the measurement(s) for flammable gases and/or oxygen concentration of the
atmosphere at the site of the hot work must be recorded on the hot work permit document.
The authoriser shall confirm the recording of these atmospheric tests on the permit. The
authoriser may, at his/her discretion, demand that such tests be repeated at intervals of 2 or 3
hours while the hot work is underway. The authoriser shall stop the hot work if unsafe results
are obtained from the repeat measurements of the atmosphere at the site of the hot work.

• After completion of the job, including housekeeping, the display copy shall be returned by the
permit holder to the applicant to be signed. The authoriser then closes the permit by signing
the permit upon inspection of the job site and receipt of the signed copy from the applicant. If
the job is not completed by the end of the shift, then work shall be stopped at the end of the
shift. The work can resume only when the PTW validity is properly extended by an authoriser
who will be present during the extension period.

Permit Applicant:

The applicant shall be normally a supervisor from the maintenance or construction department.
The applicant must be a AM/NS India employee. The applicant shall make the permit request
known to the relevant permit authoriser in the department where the hot work will be carried out.

• Prior to issue of Hot Work Permit the applicant or supervisor should inspect the job location
and ensure that the site is free from flammable materials and safe to work. This inspection
should be done jointly with the permit authoriser.

• The applicant or supervisor shall receive a properly authorised Hot Work Permit only if the
work site atmosphere is free from flammable gases, there are no visible flammable materials

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(liquids, dusts or other solids) within 10 meters of the job location, and all other required
certificates, such as Work at Height, LOTO and/or Confined Space Entry, have been obtained.

• Hot work permit shall be made in triplicate. The Permit Applicant shall take the first copy.
Second copy is for display at the site of the work and the third copy shall be retained by the
Authoriser. If the Permit Applicant appoints a Permit Holder for the hot work, then he/she
shall pass the first copy of the hot work permit to the Permit Holder. The Permit Holder shall
supervise the hot work and remain at the hot work location while the job is in progress. The
Permit Holder shall not supervise, oversee or direct any other work.

• Before commencing work, the supervisor or permit applicant shall ensure that all necessary
precautions, protections and restrictions, as listed in the permit, are in place at the job site.
The supervisor shall discuss (interactive) the precautions, protections and restrictions with his
subordinates who will perform the work and with the permit holder. The Applicant shall review
the role of the permit holder with all affected workers: the Permit Holder shall 1) supervise
and monitor the work involved in one job, 2) remain in communication with the workers, 3)
prevent access to the barricaded work site by outsiders and pedestrians moving near the
area, and 4) stop the work when conditions change and violate the safety requirements of the
hot work permit 5) The applicant should ensure the availability of required type of fire
extinguisher at work site.

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FLOW CHART FOR WORK PERMIT

Permit Applicant shall be:

Permit Applicant 1). having at least 2 years of
industrial exp.
(Person who applies for the
2) should be permanent emp.
permit) 3) max. 250 workmen will be in
his supervision.

Permit Authoriser shall be:

1) nominated by
Permit Authoriser plant/maintenance/electrical
(Person who is authorized by heads & approved by HOD.
Authoriser will the close the permit by signing off.
Permit Holder will return the permit to applicant.

HOD) 2) permanent employee

Permit Holder shall be:

1) company or contractual
employee/among the group of
Permit Holder workers.
(Person who appointed by 2) having an industrial exp.
Applicant for in charge of job) minimum 1 years.
3) have presence at work site till
the work is executed.
4) approved by the HOD.

After Completion of the Job

(Display copy shall be
returned to permit holder)

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General Safety Precautions

• While hot work is in progress, no other hazardous work, such as opening or breaking of
process lines or piping, venting of flammable gases, discharging explosive dusts or draining of
combustible liquids from nearby equipment shall be carried out. The authoriser of the hot work
permit must ensure the appropriate Line Management are aware of the hot work job.

• All the process pipe lines and/or equipment and/or vessels in the vicinity of the job location
(<10 meters), and which normally contain flammables, shall necessarily be de-pressured, gas
freed, steamed out, nitrogen purged, isolated and made free from residual process material as
per the standard operating procedure for the preparation of equipment for hot work.

• While gas cutting or welding inside a confined space, the hoses shall not remain inside that
confined space when not in use. The gas cylinders shall remain outside the confined space all
the time. The gas cylinders shall be kept in a vertical position, chained inside a trolley.

• All non-flame proof electric arc welding equipment shall be located in an area free from
flammable materials.

• If an emergency siren is sounded in the factory area where the hot work is in progress, then all
the hot jobs shall be stopped immediately. When the "all clear" signal is sounded, the permit
applicant shall obtain a renewal of the hot work permit from the permit authoriser before re-
starting the job.

• All welding machines and cables shall be thoroughly inspected by a competent engineer and
approved for use inside the factory. Tags shall be attached to such machines after inspection.
No welding machine without inspection tags (approved for use) shall be used inside the factory.
Oxy-acetylene welding/cutting shall be done with inspected and approved hoses and torches
fitted with flash back arrestors.

• When permit copies are lost, the job shall be stopped temporarily until a new permit is issued.

• Authoriser and applicant must review the requirements for hot jobs in the factory operating
areas. Hot work shall be carried out in the plant only in cases where it is not possible to carry
out the same work away from the plant operating areas. Hot work inside a fabrication shop or
maintenance building shall be done whenever possible and only final "tie-in" hot jobs shall be
done inside the operating area.

8.1.2. Cold work permit

Cold work is an activity which does not produce sufficient heat or spark to ignite a flammable or
combustible material.

8.1.2. Scope

This permit is required for all maintenance/ inspection / construction jobs other than hot work,
confined space entry, work at height, excavations, heavy lifts with cranes/hoists, electrical work
and road closure.

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8.1.2.2 Procedure
Authoriser:

• The permit shall be issued by a person authorised by the Head of the Department.

• The authoriser shall personally inspect the job location and ensure that the area is safe for
carrying out the work as requested by Maintenance/ Inspection/ Construction Applicant.

• The authoriser shall determine the safety precautions that must be taken and mention in the
permit all safety precautions, protections and restrictions to be followed without exception
while doing the job.

• The exact location, nature of job, item/equipment on which the work will be carried out, special
instructions, isolation requirements (if any), separate certificates to be obtained, etc. shall be
mentioned in the permit, also, to avoid any ambiguity in the safe execution of the job. The
Cold Work PTW is valid for one shift.

• A cold work permit is issued in triplicate. The first copy shall be taken by the Permit Applicant
and the second copy shall be displayed at the job location to make other people aware of the
job, hazards, isolations, precautions etc. The authoriser shall retain the third copy. The PTW is
valid for one shift.

• Separate certificates shall be issued for equipment isolation (LOTO), work at height, confined
space entry, etc., as required, before a cold work permit is issued for the actual job execution.
Refer to the appropriate standard(s).

• After completion of the job, including housekeeping, the display copy shall be returned by the
permit holder to the applicant to be signed. The authoriser then closes the permit by signing
the permit upon inspection of the job site and receipt of the signed copy from the applicant. If
the job is not completed by the end of the shift, then work shall be stopped at the end of the
shift. The work can resume only when the PTW validity is properly extended by an authoriser
who will be present during the extension period.

• When permit copies are lost, the job should be temporarily stopped until a new permit is
issued.

Applicant:

• The applicant is a AM/NS India employee and normally a supervisor from Maintenance,
Inspection or Construction organisation whose subordinates will perform the cold work.

• The applicant or supervisor of the job will discuss (interactive) the potential hazards,
precautions, protections and restrictions for the job with his subordinates to confirm they
understand these safety requirements before they begin the work. The supervisor will also
confirm his/her subordinates have the necessary tools, equipment, supplies and PPE, in good
condition, to perform the job.

• If the Permit Applicant appoints a Permit Holder for the cold work, then he/she shall pass the
first copy of the work permit to the Permit Holder. The Permit Holder shall supervise the work
and remain at the work location while the job is in progress. The Permit Holder shall not
supervise, oversee or direct any other work. The Permit Holder is responsible for the safe

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behaviour of his subordinates and shall direct the manner his/her subordinates are performing
the job to confirm compliance with all safety precautions and requirements mentioned in the
PTW.

• If an emergency siren is sounded in the factory area where the cold work is in progress, then
all the jobs shall be stopped immediately. When the "all clear" signal is sounded, the permit
applicant shall obtain a renewal of the cold work permit from the permit authoriser before re-
starting the job.

8.1.3 Work at height certificate

If the work shall be done at a height of 1.8 meters above ground, or adjacent to a pit or trench at a
differential height of 1.8 meters between the ground and the bottom of a pit or trench, then a
separate Work at Height certificate must be obtained, in addition to other PTW, such as hot work
or cold work. Refer to the definition of work at height. Follow the guidance in the Work at Height
Standard for the issue of a WAH Certificate.

8.1.4. Confined space entry certificate

A separate permit for Confined Space Entry must be obtained whenever the entry into a
confined space is required to perform the job. Refer to the definition of a confined space. Follow
the guidance in the Confined Space Entry Standard for the issue of such a certificate.

8.1.5 Excavation Certificate

An excavation is any man-made cut, cavity, trench, pit or depression in an earth surface that is
formed by earth removal.

8.1.5.1 Scope

A certificate for any excavation must be obtained prior to the start of digging or soil removal.

8.1.5.2 Excavation Planning

• The construction engineer, or certificate applicant, is responsible for planning the job. He or
she must involve the site’s competent person (excavation), or permit authoriser, in planning
the excavation and in all phases of the work. Every effort should be made during the design
stage of the excavation to ensure safety by providing the necessary protective systems.

• Before an excavation begins, the construction engineer in cooperation with the site competent
person (excavation) must consider specific site conditions, such as the following:

– traffic near the site of the excavation

– vibrations in the vicinity of the worksite
– proximity of structures and their conditions
– soil type
– surface water and groundwater
– chemical contamination of soil or water
– water table

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– overhead and underground utilities (buried)

– weather
- Greenery (plants, trees, shrubs, etc.)

• The location of utility installations, such as sewer, telephone, fuel, electric, water lines, or any
other underground installations that reasonably may be expected to be encountered during
excavation work, shall be located prior to starting an excavation. These underground utilities
must be located by shallow, manual digging before the actual excavation begins.

8.1.5.3 Procedure and Guidance

• The applicant for the certificate can appoint a permit holder. The permit holder is responsible
to maintain all the requirements that are mentioned below and established by the applicant
and/or authoriser before the job begins. The permit holder shall supervise one excavation job.

• The permit authorizer/competent person (excavation) shall approve the excavation certificate
when compliance to all the conditions and requirements listed below are ensured. The
excavation certificate and hot/cold work permit shall list the identification number of each other
on the certificate and permit. The first copy of the permit goes to the permit applicant, the
second is posted at the site and the authoriser retains the third copy. The permit applicant
passes his copy to the permit holder, if a permit holder is appointed.

• The permit authoriser and permit applicant shall ensure that rigid, protective visible barricades
which are painted or radium coated to be erected, at least 1.5 meters from the edge of the
excavation.

• The permit authoriser and permit applicant shall ensure that that spoil dirt, equipment or any
other materials are kept, at least 1 meter from the edge of the excavation pit or trench.

• While the excavation is open, the exposed underground utilities shall be protected, supported
or removed, as necessary, to safeguard the workers and equipment.

• At least, two means of access/egress must be provided for the pit or trench. For large
excavations, provide one ladder for every 15 meters of excavation perimeter. All access and
egress ladders, or other structures, shall not be blocked by soil or rubbish or equipment.

• Workers shall not be allowed beneath lifted loads or underneath the boom of digging
equipment at any time.

• The equipment used to dig the excavation, such as power shovels, shall be parked a suitable
distance from the edge of the pit or trench. For deep pits of 4 meters or more, the equipment
shall be parked, at least, 6 meters away from the edge of the pit or trench.

• The excavation shall be considered a confined space by the permit authoriser, if the potential
for a contaminated atmosphere or inadequate ventilation exists. In this case a separate
Confined Space Entry Certificate shall be obtained for all workmen who enter into the
excavation. Follow the Confined Space Entry Standard. A rescue plan shall be prepared and
rescue equipment shall be provided at the excavation.

• At least, a daily inspection by the competent person (excavation) shall be conducted to

determine whether or not the potential for a contaminated atmosphere or inadequate

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ventilation still exists. If the result of this inspection indicates the need, then continue to follow
the Confined Space Entry Standard. If the result of this inspection does not indicate any
threat of a contaminated atmosphere, then do not renew the Confined Space Entry Certificate,
however, the daily inspection shall be repeated twice more (3 days in a row). If the
atmosphere in the pit or trench is satisfactory and the threat of contamination is highly
unlikely, then suspend these inspections. At any time, the competent person (excavation)
may resume these inspections whenever warranted by change in conditions at the excavation.

• Diversion ditches or dikes shall be erected to prevent surface water from entering the
excavation, as necessary.

• Persons shall not work inside an excavation pit or trench in which there is an accumulation of
water or when water is accumulating (flooding).

• All trenches and pits that are 1.5 meters or deeper shall be securely shored to prevent cave
in.

• Sloping and benching of the excavation walls may be used in place of shoring. The applicant
and the authoriser shall consult with a licensed civil engineer during the planning stage to
confirm, in writing, the proper slope to use. The alternative use of sheet piling for protection
against cave in shall be confirmed by a licensed civil engineer, also.

• Daily inspections of the excavation, its protective systems (shoring, slopes, benches, etc.) and
adjacent areas shall be conducted by the authoriser (competent person - excavation) to
determine whether or not conditions have remained stable and a cave in is highly unlikely. If
conditions have remained stable, then the excavation certificate shall be renewed by the
competent person (excavation). If conditions have deteriorated, then the excavation
certificate shall be cancelled and all work at the excavation shall stop. A new excavation
certificate shall be issued when conditions have been stabilised. Such inspections shall be
done more frequently after rainstorms.

8.1.6. LOTO - Lock out / Tag out (Energy Isolation) certificate

The Permit Authoriser shall determine whether or not the equipment/vessels/pipelines must be
positively isolated before any work commences or any PTW is issued for work. A separate
certificate for LOTO shall be issued before any other permit is issued by the authoriser. Refer to
the definition of LOTO. Follow the LOTO Standard for the applying and the authorizing of a LOTO
certificate.

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LOCK OUT KEY LOST DECLARATION

Date : Time
Equipment No. :
Energy Isolation permit No.: Date of Permit :
Lock Number :
I declare that above Lock key is lost / misplaced by me/ taken away by maintenance
personnel or issuer. I confirm that the work has been completed, men and materials
have been removed from the place of work and equipment. The equipment can be
started if no other agency is working on it.

Name of Requester: Designation:

Signature : Department:
Authorized Employee (Issuer) Name:

Department:
Date : Time:
Energy Department Name & Signature:

Date: Time:

8.1.7. Certificate for Lifts with mobile crane or hoist

7.1.7.1 Scope

• This procedure applies to mobile cranes, hydras, crawler cranes, truck cranes, locomotive
cranes, powered winches, pulleys and manual hoists.

• This procedure does not apply to overhead bridge or gantry cranes, stationary jib cranes,
forklifts, conveyors, tower cranes, derricks or passenger lifts.

8.1.7.2 Permit Applicant and Permit Authoriser

• The permit applicant should be the maintenance or construction supervisor or engineer whose
subordinates will conduct the lifting or movement of the lifting equipment or loads.

• The permit applicant must comply with all the following safety requirements before and during
the lifting activities. The permit applicant can appoint a permit holder to supervise the workers
at one job. If the permit applicant serves as the permit holder, then he may not apply for any
other permit or supervise any other job. The permit applicant and permit holder for Lifts with
Mobile Crane or Hoists shall be competent persons determined through a certification process

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to be knowledgeable for Lifting and Rigging.

• The permit authoriser shall be appointed by the Head of the Department where the work shall
occur.

• The exact location, nature of lifting job, items, materials or equipment that will be lifted, special
instructions, separate permits and/or certificates to be obtained, etc. shall be mentioned in the
certificate. The Lift Certificate is valid for one shift.

• The certificate is issued in triplicate. The first copy shall be taken by the Permit Holder and the
second copy shall be displayed at the job location to make other people aware of the job,
hazards, precautions, etc. The authoriser shall retain the third copy.

• After completion of the job, including housekeeping, the display copy shall be returned by the
permit holder to the applicant to be signed. The authoriser then closes the certificate by
signing the certificate after inspection of the job site and receipt of the signed copy from the
applicant.

• The permit authoriser and applicant shall visit the site of the work to visually check the
conditions at the site. The applicant shall verify the lifting machine and accessory equipment
are in good condition and operators are certified by appropriate license. The permit authorizer
and applicant shall confirm the load weight is less than the maximum rated capacity or safe
working load of the lifting equipment or crane. The applicant shall verify that the work zone
has been properly barricaded. The applicant shall follow the Certificate for Road Closure
procedure in the event a road must be closed during the lifting activity or for movement of the
crane. In addition, the permit authoriser shall confirm that the permit applicant and his
subordinates are aware of their mandatory compliance with the general safety requirements
listed below:

8.1.7.3 General Safety Requirements

• Every operator of machinery used to lift and/or move materials shall possess adequate skill,
documented training and original government license, as per legal requirements, for the
operation of the particular lifting machine.
• All lifting machines and lifting tackles shall bear:
o Identification Number
o Safe Working Load
o Date of Last Certification Inspection

• The operator shall leave no lifting machinery unattended, while power is on or load is
suspended above machinery or above ground.

• No person shall ride on suspended loads or any lifting machine.

• A tag line or guide rope shall be used on all loads that swing freely. Guide ropes or tag lines
shall be held by trained and experienced persons. The ropes or cables shall be in good
condition and free from defects.
• All necessary precautions shall be taken to prevent injury to workers, damage to scaffolds or
buildings, from swinging loads.

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• A barricade shall be placed around the area on the ground beneath where the boom will travel
(swing radius), and surrounding the crane itself, before the crane is operated. The operator
shall not carry loads over people. Permit holder must not allow pedestrians to walk below a
suspended load or underneath the boom. If necessary, roads shall be closed to prevent
movement of people and vehicles underneath the boom. Refer to Certificate for Closure of
Roads.
• All lifting machinery shall be tested by a competent person, certified by the government, yearly
and the test record shall be maintained by the machine owner and/or Manager of Department.

• While handling materials, the following precautions must be taken:

o The load is safely secured while lifting
o Slinging method is proper for the load
o Lifted load shall not exceed the safe working load of the sling and machine
o The load shall be arranged in the sling, so that it will not collapse and does not
damage the sling.

• Belts, gears, shafts, pulleys, sprockets, spindles, drums, fly wheels, chains, and other
reciprocating, rotating, or other moving parts shall be fitted with a proper guard to prevent
contact by employees.

• A minimum distance of one-meter clearance shall be maintained between the swing radius of
the greatest extension of the crane superstructure or counterweights and a stationary object
including gas pipe lines and other utilities, including the crane itself, while the crane is in
operation. No person should approach nearer than three meters of the mobile crane, crane
truck, etc. when crane is in motion or loaded. Unathorised personnel shall remain outside the
work zone barricade at all times.

• Crane shall be parked or stationed on a firm ground when operating. All hydraulic jacking
mechanism shall be extended and positioned over load spreaders on the ground such that the
crane is in a stable horizontal position.

• When leaving the crane, the operator must:

o Lower any suspended load to the ground.
o Disengage the clutch.
o Engage all safety locks.
o Secure boom against high winds.
o
• When parking overnight, in addition to the above:
o Release the load
o Lower the boom to ground
o Provide wheel locks and wheel blocks

• Cranes must not be operated between sunset and sunrise unless there is adequate
illumination to perform the job safely. Installation of electric lights for sufficient illumination for
work at night must be indicated as a requirement in the certificate.

• When traveling up a gradient, the load shall be extended out and when traveling down a
gradient, the load shall be retracted into the minimum radius, and this position shall be
corrected on reaching level ground. Otherwise, constant watch on the radius should be
maintained while traveling on uneven surfaces.

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8.1.7.4 Proximity to Electric Power Lines

Mobile lifting equipment or lifting machines shall be operated in proximity to electric power lines in
accordance with following guidelines (except where electrical distribution and transmission lines
have been de-energized and visibly grounded at the point of work or where insulating barriers, not
a part of or an attachment to the equipment or machinery, have been erected to prevent physical
contact with the lines):
• The clearance for any movement or work with a mobile crane near to electric power lines must
be obtained by the Permit Applicant from the appropriate authority in the Utilities Department
before the movement and/or work begins.
• For lines rated 50 kV or below, the minimum clearance between the electric lines and any part
of the crane or load shall be thee meters.
• For lines rated over 50 kV, minimum clearance between the electric lines and any part of the
crane or load shall be three meters plus one centimeter for each 1 kV over 50 kV, or twice the
length of the line insulator, but never less than three meters.
• In transit with no load and boom lowered, the equipment clearance shall be a minimum of 1.5
meters for voltages less than 50 kV, and 3 m for voltages over 50 kV; up to and including 345
kV; and 5 m for voltages up to and including 400 kV.
• A person shall be designated to observe clearance of the equipment and give timely warning
to ensure that the required separation is maintained for all operations, particularly where it is
difficult for the crane operator to maintain a clear view of the separation distance from the
electric lines.

• A representative from the Maintenance electrical department or Utilities Department (electric

lines) and the lifting job supervisor must be present throughout the entire duration of the work.

• Any overhead wire shall be considered to be an energized line unless and until the person
owning such line indicates that it is not an energized line and it has been visibly grounded.

8. 1. 8 Certificate for electrical work

A certificate for electrical work must be obtained before working on electrical equipment in the
factory

8.1.8.1 Scope

The Certificate for electrical work is necessary and applicable for working on the following
equipment:

• Electric switch gears

• Electrical switch yards
• Cable cellars, cable racks, cable trenches
• Transformers and circuit breakers
• UPS systems
• Battery and battery charger systems
• Motors and motor terminal boxes
• Actuators of motorized valves

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• Junction boxes
• Motor Control Center Panels or Cabinets
• HVAC Systems
• Cathodic protection system
• Electrical heat tracing
• Electrical earthing systems
• Overhead power lines and electrical power feeders
• Electric drives
• Illumination systems (lighting)
• Electric generators

This list is not exhaustive. Guidance may be taken from competent electricians and electrical
engineers in Maintenance.

8.1.8.2 Procedure and Guidance

• Electrical isolation (part of LOTO) is required for carrying out shutdown inspection, repair or
preventive maintenance activities on any electrical equipment. No such activity shall be carried
out without proper electrical isolation. The authoriser of any electrical work certificate shall
confirm that the particular equipment is electrically isolated prior to the start of the work on it and
electric power is restored after completion of job. Refer to the LOTO Standard.

• The exact location, nature of job, item/equipment on which the work will be carried out, special
instructions, separate PTWs and Certificates to be obtained, etc. shall be mentioned in the
electrical certificate, also. The Electrical Certificate is valid for one shift.

• An electrical certificate is issued in triplicate. The first copy shall be taken by the Permit Holder
and the second copy shall be displayed at the job location to make other people aware of the
job, hazards, isolations, precautions etc. The authoriser shall retain the third copy. The
Electrical Certificate is valid for one shift.

• Separate certificates shall be issued for equipment isolation (LOTO), work at height, confined
space entry, etc., as required, before an electrical certificate is issued for the actual electrical
job. Refer to the appropriate standard(s).

• After completion of the job, including housekeeping, the display copy shall be returned by the
permit holder to the applicant to be signed. The authoriser then closes the certificate by
signing the certificate after inspection of the job site and receipt of the signed copy from the
applicant. If the job is not completed by the end of the shift, then work shall be stopped at the
end of the shift. The work can resume only when the certificate validity is properly extended
by an authoriser who will be present during the extension period.

8.1.8.3 Appointment of Authorised Electrical Persons and Competent Electrical Persons

• Any electrical job shall be supervised by an Authorised Electrical Person and carried out by a
Competent Electrical Person only. The Head of Maintenance and/or the Electrical Maintenance
Manager shall give such authorizations. A signed certificate shall be provided to all authorized
electrical persons and competent electrical persons.

• Note: Unskilled labourers who are involved in cleaning electrical equipment, such as inside

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• motor control center cabinets and the like, must always be accompanied by a competent
electrical person. An unskilled labourer is not allowed to work alone on electrical equipment or
accessories.

8.1.8.4 Competent Electrical Person

This is a person who has adequate technical knowledge of and experience with high voltage,
medium voltage and low voltage electrical equipment and systems. He has demonstrated
knowledge of safe working practices for installing and maintaining electrical systems. The
competent electrical person is qualified to work on high/medium/low voltage electrical equipment
and switchgear. The designation of competent electrical person includes the authority to be the
Permit Applicant for certificates for electrical jobs. He should have a minimum qualification of ITI in
electrical trade.

8.1.8.5 Authorized Electrical Person (Permit Authoriser)

This person has sufficient technical knowledge and experience with High Voltage, Medium Voltage
and Low Voltage electrical equipment and electrical systems. He has demonstrated knowledge of
safe working practices for installing and maintaining electrical systems. He can supervise work on
high voltage, medium voltage and low voltage electrical distribution equipment and systems. He
has full knowledge of the electrical power distribution network of his area. The designation of
Authorised Electrical Person includes the authority to authorise and cancel electrical certificates. He
should have minimum qualification of a Diploma in electrical engineering.

8.1.9 Radiography Certificate (use of radioactive material)

A Certificate is required for using ionizing radiation sources (radioactive material) to perform
maintenance, such as for inspection of welds.

8 1.9.1 Scope

This Radiography Certificate is required for all jobs dealing with radioactive sources including x-
rays and gamma ray sources, new installation of nucleonic gauges, operation and maintenance of
installed sources, radiography of weld joints and for using radioisotopes for process studies.

8.1.9.2 Procedure:

Permit Authoriser

• The permit authoriser shall be an engineer appointed by the Plant Manager, Operations
Manager or Maintenance Manager.

Permit Applicant

• The applicant shall be the Radiological Safety Officer of the plant who is qualified and
certified by Atomic Energy Regulatory Board (AERB) / Baba Atomic Research Centre
(BARC).

• Three copies of the certificate are made and distributed as follows:

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o Original - radiological officer copy

o Duplicate - display at site
o Triplicate - authoriser copy

General Safety Requirements

• The factory Safety Dept shall maintain a list of Radiological Safety Officers (RSO).

• These RSO persons are responsible for carrying out day-to-day activities related to Nucleonic
gauges, density meters, covering isolation of source and use of radiation survey meter.

• Radiation survey meters are calibrated once a year by BARC or its authorized agency.

• The location where work with ionizing radiation sources are to be carried out must be
barricaded and clearly marked with radiation warning signs. During dark hours, additional
warning lights must be placed near the radiation signs.

• The permit applicant or his designated permit holder must enforce that unauthorized persons
shall not enter the radiation zone. Consideration shall be given to persons who may be above
or below the radioactive source, also.

• When the maintenance work with the radioactive source is complete, the permit applicant
shall conduct an inspection of the vicinity with a radiation survey meter to confirm there is no
threat from radiation, then escort the contractor specialist, if any, out of the factory.

• Radioactive sources for non – destructive material analysis shall not be left without
supervision of a Radiological Safety Officer.

• Radiological Safety Officer must carry out routine checks at respective plants every 6 months
regarding availability of source and intensity of shield. The results of these tests shall be
compiled into a report and sent to BARC.

• In the event of an unusual occurrence, (e.g., fire, explosion, mechanical damage etc.) which
may affect the integrity of source holder, then the incident investigation team shall include a
radiological safety officer.

• Audits are carried out by Radiological Safety Officer to ensure that all safeguards are
implemented and records are maintained as per legal requirements. Any non-conformance
should be brought to the notice of concerned Dept Manager and Head of Safety for restoring
the same. Suggested frequency for audits is quarterly.

8.1.10 Certificate for Road Closure

The closure of any road within the factory must be done only after a Certificate is obtained.

8.1.10.1 Scope

This certificate is required for blocking of roads during execution of a particular job such as road
repairs, movement of heavy crane, painting of roads, unloading of materials using a crane which

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may block an entire road, during cleanup of spills, placing equipment, or soil from excavations or
supplies on a road, etc.

In an emergency or with imminent danger, Security personnel may block a road for a short period
of time (not exceeding 2 hours) without fulfilling requirements under this procedure. However, a
certificate for closure of roads should be obtained subsequently, if the road is to remain closed.

8.1.10.2 Procedure for Road Closure Certificate

Clearances

The Head of the Security Dept./ Admin dept. shall give the necessary clearances after duly
checking that the alternative route for emergency vehicle movement has been confirmed. The
permit applicant shall obtain these clearances.
Permit Authoriser

The permit authoriser of the Dept adjacent to the road to be closed shall authorize closure of the
road as per certificate requirement after confirming the nature of job.

Permit Applicant

The applicant shall be appointed by the Head of the Department that is seeking to close any road.

Procedure

• The road closure certificate is valid for a maximum of 7 days. The authoriser must sign the
copies of the permit every morning at the location of the job after ascertaining that the safe
conditions mentioned in the certificate are valid. In case the job is extended beyond 7 days,
then a new certificate must be obtained. However, original clearances obtained for the job
shall be attached with the new certificate, as long as the job scope does not change.

• The certificate is prepared in 3 copies. The original is kept with the applicant for record
purposes. The duplicate copy is for display at site and the triplicate is retained by the
authoriser.

• It is the responsibility of applicant to return the certificate for closure immediately after the job
is completed. It is the responsibility of the authoriser to confirm the road is unobstructed and
clean, then to inform the Fire and Security Departments regarding the completion of the job
and cancellation of the certificate.

General Safety Precautions

• The authoriser, in coordination with security personnel, must verify that appropriate traffic
signs and notice boards are installed to divert vehicles away from the work site.

• The applicant must ensure that all safety precautions as detailed in the permit are properly
followed by the employees or contractor workers.

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 • Permit to Work

• It is the responsibility of the applicant to provide warning cones, safety signs and fences or
barricades for blocking of roads during execution of work and they must remove the same
after completion of the work.

• Warning lights must be placed so that they are visible to drivers during the night.

• The applicant must obtain separate permits or certificates for hot work, cold work,
excavations, etc. and refer to those permits/certificates on the Road Closure Certificate.

8.1.11 Certificate for Gas line/ Equipment work certificate

8.1.11.1 Scope

For working on any equipment or pipeline involving natural gas, NGL, CO, Corex gas, BF Gas,
Gas holders and any hydrocarbon an additional certificate must be obtained.

8.1.11.2 Procedure

Permit Authoriser and Applicant

• The permit shall be issued by a person authorised by the Head of the Department.

• The authoriser shall personally inspect the job location and ensure that the area is safe for
carrying out the work as requested by Maintenance/ Inspection/ Construction Applicant.

• The authoriser shall determine the safety precautions that must be taken and mention in the
permit all safety precautions, protections and restrictions to be followed without exception
while doing the job.

• Competency of the persons those are going to work to be ensured before issuing the Work
Permit. Adequate PPEs, approved Scaffold, Ladders etc. to be complied including the
additional Safety precautions required for the job. Gas line / equipment have been positively
isolated and purged before allowing any work on the gas line. Emergency Preparedness and
response Plan along with the Firefighting& respiratory equipment, Gas monitors is available
at site. Regular gas test must be carried out at prescribed interval.

• Safe Limits of Gases / Vapors. Verifying all the mandatory conditions applicable for the job
by Permit Issuer, he has to authorize to start the job ensuring that the place is safe for work.
Also ensure the Safe Limit of Gases and vapors as mentioned in Part-C are adhering to for
specific gases.

• Work Permit Cancellation: If due to any reason the work is required to be cancelled or
postponed then the Work Permit will be cancelled with the remark that all work has been
suspended and the work Permit is returned to Permit authorizer for subsequent re-issue as
per requirement.

8.1.12 Certificate for High tension Line / equipment

8.1.12.1 Scope

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 • Permit to Work

Any job on Electrical high tension line / Equipment involving more than 1000 Volt will require the
addition certificate.
8.1.12.2 Procedure

Permit Authoriser and Applicant

• The permit applicant will complete detailing about the line to be isolated and the work to be
performed

• Work Starting Authorisation will be issued by operation in-charge of the working area for
de-energizing the Line / equipment.

• De-energising Authorisation for HT Line/ equipment will be issued by electrical dept after
performing it and will be sign off and informed to operation in-charge.

• Permit authoriser will authorize Work executor to perform the work. After proper isolation de-
energizing of power cable/feeder / system and ensuring Safe working conditions after
performing LOTO operation on breaker / switch as per the validity time & Date

• Pr-execution Check up for Isolated System (To be filled up by Permit Applicant or executor):
Permit executor will perform the activities and checks before starting the work to ensure Safe
working conditions.

• Job Completion authorisation: Permit executor will certify that work detailing has been
completed / stopped to due urgent requirement. All tools, equipment, man power and unused
materials have been removed. Locally provided temporary earthing has been removed.
Locks and tags are removed from the breaker / switch / Panel. The system is safe for
charging.

• Re-energized authorization (To be filled up by the authorized person of electrical dept).

8.2 Permit Validity Period, Extension of Validity and Cancellation

8.2.1 Normal PTW Validity Period

• A Permit-to-Work or Certificate is normally valid for one shift only. However, it can be
extended for a maximum of seven days more with appropriate renewals.

• A new permit and/or certificate shall be obtained after an elapsed time of seven days from
the original issue of the PTW or Certificate.

Note- If the permit holder or applicant left the working site before completion of allocated job,
then the permit & certificate to be renewed by incorporating new names.

8.2.2 Extending the PTW Validity Period

• In case the job is required to be continued beyond the shift, a PTW / Certificate extension
shall be obtained from an approved Permit Authoriser who shall be present during the
continuation of the work. Details of the extension shall be entered both in the display and

33| Version Number 1.0; Revision Number 0.02 W. e .f :- 01.09.2022.

 • Permit to Work

authoriser copies. Additional atmospheric gas tests shall be conducted and the results shall
be recorded at the proper location on the hot work permit. The permit/certificate should be
renewed upon request from the Permit Applicant. The Permit Authoriser must inspect the job
location before renewing the permit/certificate.

8.2.3 Cancellation of a PTW or Certificate

• If an emergency siren is sounded in the factory area where work is in progress under the
authority of a PTW or Certificate, then that job shall be stopped immediately. When the "all
clear" signal is sounded, the permit applicant shall obtain a renewal of the PTW or Certificate
from the permit authoriser before re-starting the job.

• A Permit Authoriser shall cancel or withdraw a PTW or Certificate whenever a change in

conditions at the site of the work has invalidated or violated a necessary precaution, protection,
restriction or other safety requirement specified in the original or renewed PTW or Certificate.

• The Permit Authoriser shall cancel the PTW or Certificate whenever any conditions have
rendered or caused the situation at the site of the work to be unsafe (e.g. rain with lightning has
made it unsafe to proceed with work at height, flooding of a pit or trench has made it unsafe to
continue with excavation work, high winds have made it unsafe to proceed with heavy lifts with
a mobile crane, etc.) The PTW or Certificate must be renewed after the adverse conditions
have ceased.

8.3 Span of Supervision for Permitted Work

8.3.1 Permit Holder

• The permit holder shall be in charge of only one job. He/she shall remain at the site of that
one job always and direct the primary work as specified in the permit or certificate. He must
ensure that workers and conditions are meeting the safety requirements of all relevant
permits and/or certificates for one job (e.g. the job may involve hot work inside a confined
space while working at height).

8.3.2 Permit Applicant

• Permit Applicants may apply for up to, max. 250 workmen will be in his supervision.
provided the following conditions are met:
o The applications must be for similar work according to function, such as only
structural jobs, or only electrical jobs, or only hot work jobs, or only civil jobs, or
only insulation jobs, or only mechanical jobs, or only painting jobs or only
radiography jobs.
o The applications must be in the same geographic area, such as the same plant or
the same construction site or the same maintenance shop.
o The applications must involve a reasonable total number of workers who are
performing the permitted jobs under the guidance of permit holders. So, a
maximum of 250 workers are allowed.

• Permit Applicants who serve as Permit Holders shall not apply for permit(s) or certificates for
any other job or have any other responsibilities.

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 • Permit to Work

9.0 RACI Chart

The roles and responsibilities to implement this standard are outlined below:

HOD or Line
Activity Description Authorizer HSE
Management
Identification and assessment
R A C
of the site conditions
Planning and Preparation and
the Risk Assessment of the R A C
work
Assign responsibility for
implementing safety &
R A C
environmental controls at the
job
Implement the Permit-to-Work
R A C
Standard
Prohibit working without PTWs
through discipline &
termination, if necessary
R A C

HOD or Line
Activity Description Authorizer HSE
Management
Train and certify AM/NS INDIA
employees on PTW Standard & R A C
contractors, as necessary
Train and certify AM/NS India
employees on other safety stds:
R A C
LOTO, WAH, Confined Space
Entry, etc.
Appoint Permit Authorisers to
R,A C
approve PTWs
Maintain records of PTWs, as
R A C
required in this Standard
Inspect and either approve or
reject electrical tools, welding
machines, hoses, cables,
R A C
cranes, hoists, Lifting Tools &
Tackles, hydras, rescue
equipment, etc.
Periodically audit the
- R/A R/C
compliance to PTW Standard
Identify First Aid & Rescue
R A C
Team

R: Responsible
People who are expected to actively participate in the activity and contribute to the best of their

35| Version Number 1.0; Revision Number 0.02 W. e .f :- 01.09.2022.

 • Permit to Work

abilities.
A: Accountable
The person who is ultimately responsible for the results.
C: Consulted
People who have the specific expertise and can contribute to decision making.
I: Informed
People who are kept informed, but do not necessarily participate in the effort.
10.0 Management Systems
10.1 Support Resources
Safety Dept is available to assist with implementation of this standard, such as provision of
safety equipment, rescue equipment and arranging for inspection of tools and tackles.

10.2 Management Records

Work permits, certificates and audit checklists records shall be retained by the department for
two years or until the completion of the project, whichever is later.
Records to be maintained are as follows:
o Periodic Inspections of electrical equipment for 6 months.
o Periodic Inspections of welding machines for 6 months.
o Periodic Inspections of cables, hoses and torches for 6 months.
o Periodic Inspections of lattice crane booms for 1 year.
o Periodic Inspections of cranes, slings, lifting cables, hoists and chains for 6 months.

10.2.1 PTW Training Records

Records to be maintained are as follows:

o The completion of training of each person every two years on Permit-to-Work Standard

10.3 Audit Requirements

Each department shall conduct an annual first party [self] audit of the compliance with this
standard as part of its safety audit program. Every two years a 2nd Party audit of the
compliance to the PTW Standard shall also be conducted for an objective assessment of
another department's performance.

10.4 Standard Renewal Process

This standard shall be reviewed and revised as necessary, at least, not later than three years
from the date of the last revision.
10.5 Deviation Process
Deviations from this standard must be authorized by the DIC of the affected area after
consultation with the Central Safety Committee. Deviations must be documented, and
documentation must clearly indicate the justification for the deviation. Deviation authorization
must be renewed periodically and at no less frequently than every three years.

10.6 Training and Communication Requirements

Any person who is authorized to issue or receive the work permit shall be imparted training
for a period of not less than one day covering various aspects of work permits system.

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 • Permit to Work

Further all the person authorized to issue/ receive the work permit shall be given a minimum
of one-day training once in two year on the work permit system and records maintained.

Training and awareness programs are to be organized from time to time for issuer & receiver
of permit to make them conversant about work permit system. These programs should
include “class room” as well as “on the job training” like

• Filling of permits, assessing hazards and correction, Work Permit procedure

• Atmosphere monitoring with portable gas testers.

• Use of PPE including SCBA & airline respirators

• Carrying out different jobs safety

Awareness programs should be arranged in the form of “Class room training” as well as “On
the job training” for contractors (Supervisor and their workmen) about work permit system.

10.7 Contact
In the event that interpretation or clarification is needed, questions shall be directed to the
concerned departmental PHSE.

11.0 Appendix

(Blank permit forms)

1. HOT / COLD Permit to Work

2. High Tension Line/ Equipment

3.Gas line/ Equipment work

4. Confined Space Certificate

5. Working at Height Certificate

6. Lock Out Tag Out Certificate

7. Electrical Certificate

8. Heavy Lift Certificate

9. Hydra (pick & carry crane) Certificate

10. Excavation Certificate

11. Certificate for Closure of Roads

12. Radiography Certificate

37| Version Number 1.0; Revision Number 0.02 W. e .f :- 01.09.2022.

 ArcelorMittal Nippon Steel India Limited AMNSIL/SAFE/F/01 Rev. No. 13
(Formerly Essar Steel India Limited)
Hazira
PERMIT TO WORK
Hot Work Cold Work Permit No. Certificate No.
Copies: Pink – Permit Applicant / Holder, Green – Work Site, White – Authoriser
APPLICATION AND WORK DESCRIPTION (Filled by Applicant):
Planned Work Schedule Date: From ………………. To ..……………… Time: From …..……………. To ….…………………
Plant: …………………………………………………………………. Location: ………………………………………………………………………….
Work Description: ………………………………………………………………………………………………………..................................................
……………………………………………………………………………………………………………………………………………
Equipment Name: …………………………………….……………………. Equipment ID No.: ………………………………………………………..

Applicant: Sign …………… Name: ………………..………… Authorisation for shut down: Sign: ……..….. Name: ………………...…………….

SPECIAL PRECAUTIONS & POTENTIAL

SAFETY MEASURES TAKEN
1 REMARKS 2 HAZARDS
BY OPERATIONS
FILLED BY APPLICANT / AUTHORISER
1.1 2.1 HIRAC No.
1.2 2.2 SOP No.
1.3 2.3
1.4 2.4
1.5 2.5
1.6 2.6
1.7 2.7
1.8 2.8
1.9 2.9
2.0 2.10
Sign Sign
Name Name
PPE, FIRE PRECAUTIONS, GAS TEST & ASSOCIATED CERTIFICATES TO BE FILLED BY PERMIT APPLICANT
3B-FIRE PRECAUTIONS 3C – CERTIFICATE
3 3A- PPE & OTHERS REMARKS REMARKS
& GAS TESTS CERTIFICATES NOS.
Confined Space
3.1 Eye, Face & Ear Protection Competent Fire Watcher
Entry
3.2 Head Protection Fire Extinguishers LOTO
Body Protection, Full Body
3.3 Pressure Fire Hose Electrical
Safety Harness
3.4 Repiratory Protection (BA Set) Fire Tender Working at Height
3.5 Leg Protection Screen off Area Excavation
3.6 Portable CO Meter Explosive Test Heavy Lift
3.7 Roof Ladder/Gas Cutting Sets Carbon Monoxide Test Road Closure
Safe means of access/
3.8 Oxygen test Radiography
Scaffolding/ Enclosures
Gas Line
PERMIT APPLICANT PERMIT HOLDER

SIGN: …………………..… NAME: ……………………………………… SIGN: …………………..… NAME: ……………………………………

Contact No. ………………………....… Contact No. ………………………....…
PERMIT AUTHORISER
PERMIT VALIDITY Date: From ……………. To ……………. Time: From: ……………. To ……………
SIGN: ……………………… NAME: …………………………………… CONTACT NO. …………………………..
AUTHORISER NOMINEE SIGN: ……………………… NAME: ………………………………….... SAP ID: …………………………….
4A PERMIT RETURN – WORK COMPLETE 4B PERMIT RETURN-WNC PERMIT CANCELLATION
Permit Return by Permit Holder: Work Complete Permit Return by Permit Holder: Work Not Complete (WNC)
Work Site & Equipment affected Left in Safe Condition Work Site & Equipment affected Left in Safe Condition
4.1 5.1
Sign:……………………… Name: ……………………………. Sign:……………………… Name: …………………………….
Date: …………………….. Time: …………………………….. Date: …………………….. Time: ……………………………..
Permit Return by Applicant Permit Return by Applicant
4.2 Sign:……………………… Name: ……………………………. 5.2 Sign:……………………… Name: …………………………….
Date: …………………….. Time: …………………………….. Date: …………………….. Time: ……………………………..

Permit Accepted by Authoriser Permit Accepted by Authoriser

4.3 Sign:……………………… Name: ……………………………. 5.3 Sign:……………………… Name: …………………………….
Date: …………………….. Time: …………………………….. Date: …………………….. Time: ……………………………..
PERMIT RE-VALIDATION

Time APPLICANT HOLDER AUTHORISER

DATE
From To SIGN NAME SIGN NAME SIGN NAME

SAFE LIMIT OF GASES / VAPOURS

SAFE CONCENTRATION FLAMMABLE LIMITS
GAS FOR
8 HRS DURATION LOWER UPPER
CARBON MONOXIDE 50 PPM 12.5 % 74.2 %
HYDROGEN - 4.0 % 75 %
METHANE / NATURAL GAS 1000 PPM 5.9 % 14 %
AMMONIA 25 PPM 16 % 23 %
CHLORINE 1 PPM - -

IMPORTANT INSTRUCTIONS:
1. A Permit-to-Work or Certificate is normally valid for one shift only. However, it can be extended for a maximum of seven days more with appropriate
renewals.
•

2. Permit is not valid in the event, if conditions in the incident area become Hazardous from conditions not existing when this permit was issued/ or in the
event of any Emergency / Fire.
3. The authorized person should issue permit only.
•

4. Work Instructions & Protocol procedures are to be strictly followed.

•

5. If job is not completed within the validity time period, the authorized person incorporating necessary changes must extend the permit.
•

6. Permit must be returned by the applicant to the issuing authority after completion of the job.
•

7. When more than one agency is working at a place the concerned agencies must co-ordinate among themselves for safety of the persons working
there.
•

8. No job should be attempted / to be done for which permit is not issued.

•

9. Workers must be briefed about imminent dangers involved in the job.

•

10. Persons working at height and Confined Space should be medically checked for acrophobia and claustrophobia respectively.
•

11. Separate Certificates are to be taken for the jobs involving Excavation, Confined Space Entry, Working at Height, Radiography, Electrical, LOTO,
Road Closure & Heavy Lift jobs.
•

12. Results for the Confined Space Entry to be periodically recorded on the Certificate.
•

NOTE: If the Applicant does not fill it, Authoriser can fill it up if necessary or write “NIL”

BEFORE AUTHORISING THE PERMIT

ENSURE THAT SITE IS SAFE TO WORK & SAFE WORKING CONDITIONS ARE MAINTAINED

LEGEND Measures Taken Measures Not Required NA Not Applicable

 ArcelorMittal Nippon Steel India Limited Certificate No.:
HAZIRA
Permit No.:
ADDITIONAL WORK PERMIT FOR HIGH TENSION
LINE/Equipment
Part - A : REQUEST TO WORK ON HT LINE (To be filled-up by Requisitioner / Executor) For 1000 V and above
Power Line to be Isolated Cross Ref. Permit No:
Plant will be affected Dept. & Location
Description of the Job
Validity From Date at AM / PM to Date at AM / PM
Part - B : WORK STARTING AUTHORISATION FOR HT LINE (To be filled-up by Operation-In-Charge of working area)
The above mentioned equipment / related power cable may be de-energized as requested.
Authorised Person Name Signature Contact No. Date Time
Permit Requisitioner
Permit Issuing Autho.
Part - C : DE-ENERGISING AUTHORISATION FOR HT LINE (To be filled by Authorised Person of Electrical Operation)
Sr. Activity Yes NA Remarks
1 All back feeding circuits checked & isolated
2 Control supply switched off
3 Breaker/MCC switched off & front lid opened
4 Breaker racked out & control plug removed
5 All fuses pulled out and kept at proper place
6 Back cover / lid of Breaker Panel opened
7 Breaker / MCC internals visually checked
8 No line voltage observed on Voltage Test using Voltage detector
9 Line discharged through Earth Rod
10 Temporary earthing provided
11 Breaker/ MCC back/front lids [covers] closed
12 LOTO performed on Breaker/MCC Module
The above mentioned power cable [Feeder] / equipment is de-energised after performing above Checks / Activities
Authorised Person Name Signature Contact No. Date Time
Electrical Dept.
Part - D : PERMIT TO WORK AUTHORISATION (To be filled by Permit Issuing Authorities)
Permit is hereby issued to Mr. for working on
From Hours on Dated To Hours on Dated after proper Isolation / de-energise of the power
cable / feeder / system and ensuring safe working condition after performing Lock out and Tag out (LOTO) operation on Breaker /
Switch. This permit is valid till the return of job completion AUTHORISATION.
Authorised Person Name Signature Contact No. Date Time
Permit Issuing Autho.
Part - E : PRE-EXECUTION CHECKUP OF ISOLATED SYSTEM (To be filled-up by Requisitioner / Executor)
Sr. Activity Yes NA Remarks
1 Breaker is in racked out position
2 No line voltage observed on cable discharged by grounding.
3 No line voltage observed on Voltage Test using Voltage detector
4 Local earthing provided
5 LOTO done on Breaker / MCC Module
Above checkup of the Isolated cable / equipment has been done before starting the work to ensure safe working condition.
Authorised Person Name Signature Contact No. Date Time
Permit Requisitioner
Part - F : JOB COMPLETION AUTHORISATION (To be filled-up by Requisitioner / Executor)
This is certify that the work detailed in Part-A has been completed / stopped due to urgent requirement. All tools unused material
& manpower have been removed. Locally provided temporary safety ground has been removed. Locks & Tags is safe for charging.
Authorised Person Name Signature Contact No. Date Time
Permit Requisitioner
Part - G : RE-ENERGISING INSTRUCTION FOR ISOLATED POWER LINE (To be filled by Permit Issuing Authorities)
Job completion authorisation has been received from the Requisitioner / Executor for the power line de-energized earlier.
No other job clearance has been issued on this power line. Affected plant is in agreement with the proposal.
Authorised Person Name Signature Contact No. Date Time
Permit Issuing Autho.
Part - H : RE-ENERGISING AUTHORISATION (To be filled by Authorised Person of Electrical Operation)
Sr. Activity Yes NA Remarks
1 Damaged internals of Breaker / MCC rectified
2 Temporary earthing removed
3 IR Value of Cable/Equipment Checked-found O.K.
4 Back lid / cover of Breaker boxed up
5 All Locks & Tags of Breaker removed
6 All fuses put back in place
7 Breaker control plug put back in place
8 Breaker checked in test position & found O.K.
9 Trip circuit found healthy
10 Breaker racked in to service position
11 Control supply switched on
12 Breaker / MCC Module front door closed
13 MCC [MCC Module] switched on
14 All cabels are dressed properly
The work detailed in Part-A power cable (Feeder) is re-energised after performing above Checks / Activities
Authorised Person Name Signature Contact No. Date Time
Electrical Dept.
 ArcelorMittal Nippon Steel India Limited Certificate No.:
HAZIRA
ADDITIONAL WORK PERMIT FOR GAS LINE / EQUIPMENT Permit No.:

Part - A : AUTHORISATION TO WORK (To be filled-up by Permit Issuer)

Issuer Name Cross Ref. Permit No:
Department Location
Description of the Job
Validity From Date at AM / PM to Date at AM / PM
Part - B : MANDATORY CONDITIONS (To be filled-up Jointly by Permit Issuer & Acceptor)
Sr. Activity Yes NA
1 Are persons authorized (trained & competent) to enter / work in the gas proximity area?
2 Certified that the gas lines / equipment positively isolated?
3 Certified that the isolated gas lines / equipment completely purged by Nitrogen gas?
4 Are chemical analysis carried out of the sample taken after purging by Nitrogen gas?
5 Are the emergency escape routes checked & ensured? And Emergency Response plan in place?
6 Are all the PPEs. & firefighting equipment available, appropriate & in good condition?
7 Are the Breathing Apparatus Set etc. Available?
8 Are non-sparking tools or intrinsically safe electrical fittings and portable hand lamp used?
9 Are all mobile phones prohibited at work place?
10 Are required personal gas monitors available with persons working in the area?
11 Ensured that during operating the bleeder the gas is not allowed to blow over any person?
12 Ensured that the work will be started after checking the concentration of CO / toxic gases?

Part - C : SAFE LIMITS OF GASES / VAPOURS (To be checked By Permit Issuer & Permit Acceptor)
Gas Safe Conc. For 8 Hrs. Lower-Flammable Limit Upper-Flammable Limit
duration
Ammonia 25 ppm 16.0% 25.0%
BF Gas 50 PPM 45% 70%
Carbon Monoxide (CO) 50 PPM 12.50% 74%
Corex Gas 50 PPM 10% 72%
Coke Oven Gas 50 PPM 6.00% 30%
Chlorine (Cl ) 0.5 ppm --------- ---------
DRI Tail Gas 50 PPM 27% 87%
Hydrogen (H ) --------- 4.0 % 74.0 %
Hydrogen Sulphide (H s) 10 ppm 4% 46%
LPG 1000 ppm 2.2 % 9.9 %
Methane / Natural Gas 1000 ppm 5.9 % 14.0 %

Part - D : PERMIT AUTHORISATION (To be filled-up by Permit Issuer)

I confirm that the above location have been examined, the safety precautions taken as per the check list. The permission is authorized for this
work. I also accept responsibility for the work to be carried out safety.

Authority Name Signature Contact No. Date Time

Permit Issuer

Part – E: Work Permit Closure (To be signed by Permit Issuer & Permit Acceptor)
I confirm that the work has been completed / partially completed, checked by myself and the area is left in a safe condition.
Author Name Signature Contact No. Date Time
ity
Permit
Acceptor
I have inspected the finished work and hereby cancel / Close this permit.
Author Name Signature Contact No. Date Time
ity
Permit Issuer

LEGEND Measures Taken Measures Not Required NA Not applicable

 Confined Space Entry Certificate

THIS IS NOT A PERMIT TO WORK

Certificate No.
Yellow - Permit Applicant / Holder, Green-Work Site, Blue-Authorizer

1. APPLIED BY PERMIT APPLICANT (To be filled by Applicant)

Sign:_____________________ Plant:____________________ Permit No:

Name:___________________ Confined Space Identification No
:____________
Date:____________________
Location Of Confined
Space:________________

Description of Confined Space: Work Description: Equipment/Tools/Chemicals used

for this work:

2. TYPE OF HAZARDOUS WORK

Combustion Hazards Spark Producing

Welding Chipping Electrical

Burning Grinding Rotating space

Open flame Drilling Task-generated

Other Hazards

Toxic material Spilled material Adjacent processes Working on unguarded

equipment
Corrosive material Flammable material Hot equipment or Other
process

Biological agents Electrical close Radioactivity

clearance

Chemical and jet Fall prevention Tightening joints under

cleaning pressure

Disconnect and blank Hazardous materials Welding fumes and

from drains, sumps heat
3. SAFETY PREPARATIONS

Personal Safety Space Preparation Equipment Cleaning and

Draining
Protect against by Isolate Steam

Fresh air blower Rubber boots Lockout/tag out Fill and drain

Fresh air mask Ear protection Disconnect and blank Remove deposits

Escape air pack Other barrier clothing Post work signs Visual inspection

Dust respirator Evacuation instructions Rope off work area Neutralize contents

Coveralls Two escape routes Erect barricade

Safety shower Life-line harness Block roadway Fire Safety

Acid suit Life-line belt/wristlets Protect against Specify fire watch in

external hazards "Remarks"

Acid hood Chemically resistant Area alarm no.

lifeline

Face shield Fire alarm box Electrical Precautions Fire hose laid out

Chemical goggles Escape ladders Lock out circuits Water hose running

Rubber gloves Mechanical extraction Pull fuses Keep area wet

device

Communications: Telephone Spark containers and Cover sewer openings

Radio Other shields

Location/type of additional assistance (third alternate) Welding-arc CO2 extinguisher

protection

Remarks Ground fault Dry powder extinguisher

interruption
Proper grounding Other

4. Any Other Observation

Person Carrying out the test Name___________________ Signed________________

 5. CHECK LIST Items to be checked by Area In charge before confined
space entry can proceed

Required
Yes
No NA
1. a. The above equipment has been isolated from all source of dangerous liquid,
gases and fumes by insertion of spades or by removing a section of pipe work and
blanking open end of the circuit

b. Equipment has been isolated from all source of electrical and mechanical power

2. Equipment free of all dangerous materials. All flushing /inert gas purging completes,
all liquid drained and ventilation atmosphere restored on confined space

3. Equipment surrounding area checked and safe from hazard arising from other
work /operation

4. Life line, breathing apparatus and resuscitation equipment available

5. Adequate access and escape routes are provided

6. Fresh air supply equipment installed and operational. vessel sufficiently cooled for

Access.

7. Procedure and rescue plans formulated and discussed with permit holder, personnel
entering vessel and stand by personal. vacation exercise conducted where stated as
required on permit

8. Stand by personal appointed

9. Fire Extinguishers / Fire Hydrant line available?

10. All persons engaged for working provided required training?

Nam Name of the Area In charge _______________ Signature ______________

Date______________ Time__________

6. GAS TESTING

RESULT OF TEST GAS LIMIT RESULTS

OXYGEN 19-21 % VOL %
HYDROCRABONS 0% LEL for Hot %
work
CO 50 PPM (0.005%) PPM
NH3 <15 PPM PPM
TEMPERATURE ⁰ C
DUST 10 mg/Cu.M mg/Cu.M
Any other Fumes
Confined Space Tested

I have tested this space for the above gases, with the results shown

Na Name_______________ Signature______________ Date______________

Ti Time __________
 GAS TESTER

7. TEST HAVE BEEN CARRIED OUT IN THE ABOVE MENTIONED CONFINED SPACE AND ENTRY IS
PERMITTED AS INDICATED BELOW;

Recommendation for Periodic Checking____________________________________

(Subsequent gas testing reports shall be recorded)

Entry into the confined space is permitted With / Without Breathing Apparatus.

From Date_______________ Time__________________________.

Until Date_______________ Time__________________________

Entry wearing Breathing Apparatus subject to the following conditions

i. An observer must be positioned outside the confined space.

ii. Where practicable, each man is wearing belt or harness with life line attached and that the observer
positioned outside is holding the free end of the life line and is capable of pulling out the men.

8. PERMIT APPLICANT AND PERMIT HOLDER 9. PERMIT AUTHORISER

I understand all the above safety precautions. I will I certify that the above results indicate
ensure that work only take place when all these safety that the confined space covered by this
precautions are complied with. certificate is safe to enter.
PERMIT APPLICANT PERMIT HOLDER

Sign :_________________ Sign Sign:_________________ Date

:_________________ :__________

Name:________________
Name:________________ Name:________________ Time
:__________
Date :_________________ Date
:________________

Time :_________________ Time

:________________
 RETURN OF ‘PERMIT TO WORK’ AFTER JOB COMPLETION
The work planned inside the confined space is completed / incomplete / not taken up. The confined
space and the equipment therein are left in safe condition. The permit to work Permit No: _________
issued based on this certificate shall be closed.

PERMIT APPLICANT PERMIT HOLDER

Sign: _________________ Sign: _________________

Name: ________________
Name:________________

Date & Time: ___________ Date & Time :____________

This Certificate for Confined Space Entry is cancelled

Sign of the Authoriser : _____________________ Date & Time

:____________
Name of the Authoriser: __________________

Confined-space Entry Log & Subsequent Gas Test Records

Confined Space Identification Number : Unit/Location :

Date:

All entrants and attendants have been instructed about potential hazards, safety precautions, and
specified protective emergency equipment.
 1. Confined-Space Entry Log
Time
Name (all persons entering or attending) Time in Initials Initials
out

2. Subsequent Gas Test Record

DATE TIME RESULTS OF GAS TETS SIGNATURE
CO O2 NH3 HYDROCRABON OF GAS
TESTER
 Confined-space Rescue Plan

(This must be attached to the Confined Space Certificate)

Date: – Time: -

Emergency telephone numbers:

Exact Location of the Entry:

How will the Emergency Response Team be summoned?

Method of rescue:

Rescue Equipment Required for Safe Rescue:

Will the rescue equipment be located at the point of the rescue? Yes No

If no, where will the rescue equipment be located?

Describe any likely hazards the rescue team may face and how they will be controlled?

Signature of person approving initial rescue plan __________________________________

 WORKING AT HEIGHT CERTIFICATE

THIS IS NOT A PERMIT TO WORK

Yellow - Permit Applicant / Holder, Green-Work Site, Blue-Authorizer
Permit No. Certificate No.
Section: 1 To be filled in by Permit Applicant
Date of Issue Permit Valid From …………….…….. To
………………..………………………………...,
If Permit Applicant / Holder changed then their Name & signature should be
incorporated in the format
Applicant's Name Sign Dept.

Location
Description of work

Action Taken by Permit Holder: Please tick the relevant action taken in the box provided.
Sr.No Safety Checks for compliance Yes No NA
1 Risk Assessment is been carried out for the job & attached with this permit (MANDATORY
REQUIREMENT)
2 Contractor & their workmen have been fully briefed about the risk associated to the job.
3 Whether safe access to work place is provided
4 Work platforms provided with guard rails
5 Adequate fall protection arrangement made (Double Lanyard Harness, Fall arrestor, Life line,
Safety Net)
6 Are the workmen are medically fit for working at height job
7 Is the work area away from the vicinity of moving objects
8 Protection against objects falling from above height
9 Whether area below, where the height work being performed is cordoned & unauthorised entries
are restricted
10 Work at more than one elevation at the same segment is restricted
11 Other specified precautions
Name of Permit Authoriser Department Signature Date Time

Section-2 : Acceptance (Permit Holder)

I understand the work which is to be carried out and the Name : Date & Time
method of work to be used to ensure that it is carried out Signature :
safely.
No work will be carried out other than the work authorised by
this permit
Extension / Transfer of permit All checks reviewed & found OK to extend permit Remarks
Date Time Permit Holder Permit Applicant Permit Authoriser
Signature Signature Signature
From To

Section-3 : Completion To be completed by the Permit Holder after completion of the work & handed over to
(Permit Holder) Permit Applicant / Authorizer
Permit Holder Signature
Date & Time
Section-4: Cancellation: I declare that this permit is now cancelled. No further work at height is allowed until a new permit is
issued
Permit Applicant Permit Date Time Remarks
Authoriser

Note 1. This permit Applies only to work in the location described. Any further height work must have another
: permit issued for prescribed validity
2. This permit only applies to the person to whom it is issued. If work has to be continued by someone else,
this permit must be returned to issuer for cancellation and another permit issued.
 LOCK OUT TAG OUT CERTIFICATE AMNSIL/SAFE/F/02
Pink - Permit Applicant / Holder, Green-Work Site, White-Authorizer
THIS IS NOT A PERMIT TO WORK
1.0 APPLIED BY PERMIT APPLICANT (Applicant has to take the clearance from all the concerned dept.)

Sign…………………………… Plant…………………………………….
Certificate No………….
Location…………………………………
Name………………………….
Equipment to be isolated……………...
Date…………………………… Cross Ref. Permit No ………………
……………………………………………
Time…………………………… Equipment ID No. ……………………..

1.1 Permit Authorizer Name: Sign: Date: Time:

2.0 ELECTRICAL ISOLATION

Controls Padlock No. Tagged (Yes /No) Remarks
2.1
2.2
2.3
2.4
2.5
2.6
2.7
I hereby confirm that above isolation and precautions have been taken, the equipment has been proven isolated by test
and all concerned/ affected individuals has been adequately informed.
Name of the Authorized person
Performed Isolation
Name……........................................................ Sign……………………………….
Date………………………………………………. Time……………………………….
3.0 RECEIPT OF CERTIFICATE BY PERSON
IN CHARGE OF WORK.
Name……............................... Sign……………………………….
Date………………….………… Time………………………………
4.0 MECHANICAL ISOLATIONS
Controls (Mechanical, Padlock No. Tagged (Y/N) Remarks
Pneumatic, Hydraulic, etc,)
4.1
4.2
4.3
4.4
4.5
4.6
4.7
I hereby confirm that above isolation and precautions have been taken, the equipment has been proven isolated by test
and all concerned/ affected individuals has been adequately informed.
Name of the Authorized person
Performed Isolation
Name……...................................................... Sign……………………………….
Date………………….…………………………. Time………………………………..
5.0 RECEIPT OF CERTIFICATE BY PERSON
IN CHARGE OF WORK.
Name……........................................... Sign……………………………….
Date……………………………………. Time……………………………….
6.0 TRIAL AND TESTING

Permit Holder Permit Applicant De-Isolator

Date Time Name Sign Name Sign Name Sign
7.0 COMPLETION OF WORK
I hereby confirm that the task detailed in section 1 above is completed, the personnel and equipment withdrawn
and the isolation may now be removed by a competent person.

Applicant Name: ……………………. Sign…………………… Date……………… Time……………

8.0 CONFIRMATION OF DE-ISOLATION
I hereby confirm that the isolation detailed in section 2/4 has been removed and the system energized.

a. Authorized person Sign………………. Date…………………… Time…………………

b. Authorized person Sign………………. Date…………………… Time…………………
Note: Authorized Person is either Mechanical / Electrical or both
9.0 LONG TERM ISOLATION
I hereby confirm that the task detailed in section 1 above is not completed and the equipment has been entered
as a “Long Term Isolation”, I have placed the equipment isolation keys and a copy of this certificate in the “Long
Term Isolation Box”,
a. Permit Applicant: Sign………………… Date …………………. Time………………
b. Area Authorizer: Sign….……………... Date …………………. Time………………
 ELECTRICAL CERTIFICATE
THIS IS NOT A PERMIT TO WORK

Yellow - Permit Applicant / Holder, Green-Work Site, Blue-Authoriser

Hot work / Cold Work permit - Permit no. _____________ Certificate No: _________

A) Plant/Area: _____________________________ Equipment Tag No. : _______________________________

Location of the job :_________________________________________________________________
Details of the job : ________________________________________________________________
_________________________________________________________________________________
Name of the contractor : No. of Workers :
B) Clearance by Operations
Clearance from operations dept. is hereby granted for carrying out the above job.
Name Signature Date Time

C) Precautions taken( Tick mark which are applicable, strike out whichever not applicable )

Normal supply Alternative supply _____ Earth continuity checked

_____ _____ Switches put ' Off ' _____ Use electrical gloves rated 11/33 KV.
_____ _____ Power fuse remove _____ Other? _______________________
_____ _____ Control/space heater fuses removed
_____ _____ Breaker racked out
_____ _____ Do Not Operate tags provided, Tag No. ________
_____ _____ Terminal / Cable earthed and short circuited.
D) Special instructions :
_________________________________________________________________________________
_________________________________________________________________________________
E) Applicant & Authorizer : Certify that the precautions are fulfilled and work site plus equipment are ready and safe
for the job
Permit is valid upto _________ hrs. on ____________ unless extended as per section F.

Designation Name Signature Date Time

Applicant Certified Electrical Person

Authoriser Certified Electrical Person

Holder Certified Electrical Person

F) Extension of Validity (to be renewed every shift - max. validity - 24 Hrs.)
Conditions checked and the permit is re-validated as under :

Applicant Authorised by Extended up to

Name Signature Name Signature Date Time

Extension 1

Extension 2
G) Job completion and closure of certificate: Job is completed and we have inspected the site & found the area
cleared of men and materials. Temporary earths also removed.
Certificate is hereby closed.
Name Signature Date Time
Authoriser
Applicant
Holder
 Heavy Lift Certificate
Yellow-Permit, Holder Green-Work Site, Blue- Authoriser

Permit No……………………………………….. Certificate

No………………………………………
Location Date Time
THIS IS NOT PERMIT TO WORK
Lift Information
Description of Load :
Weight of load
Dimensions
Equipment & Load information
Crane
Type
Model
Competent Person Test Certificate Validity
Crane Information
A. Maximum Operating Radius
B. Main boom length
C. Jib length
D. Jib Offset
E. Attachments (Luffing jib, Super lift)
F. Counterweights required
G. Vertical Clearance between boom Hook & load
Competency of Crane Operator ( Mention the Details )
Driving License :

Medical Fitness :

Certified ( OEM ) Training :

Crane operator Name: Sign:

Site Conditions
H. Obstructions
I. Distance from power lines
J. Ground Stability
K. Underground utilities
L. Wooden Stoppers or mats needed ?
Calculations
M. Lifting Capacity
N. Weight of load
O. Total weight of accessories
P. Total weight of lift (N + O)

*Authorised Engineer Name: Signed:

*Authorised engineer must undergo Permit to Work, Lock Out and Tag Out, Working at Height, Confined Space
Entry Trainings
 Pick & Carry Crane (Hydra Certificate)
THIS IS NOT PERMIT TO WORK
Yellow- Permit Applicant/ Holder, Green- Work site, Blue Authorizer Copy

Activities Persons Conditions of

(Sequence Responsible Tools/Tackles required- Reference to documents/ Criteria and
S.No. of Work) Hazards Safety Precautions Name Ok/ Not Ok Remarks
General Competent Person Test
check to Certificate
de done Operator Fitness (a) OEM
before Training (b) License (c)Medical
starting Fitness
the Hydra Check the crane for any leakage
1 Crane in Hydraulic System
Inspect the boom for any
damage or defects

Before starting the hydra crane

check all
Handling Proper Handling of hydra will be
of done as per hydra
material manufacturer chart
by Hydra
Hydra movement area ( 40 mtrs
with in fabrication yard) will be
clear & 8m width road will be
provided.
Hydra to be placed on level
2 Toppling of Hydra ground.
Overloading of hydra will not
allow while working at site
Testing slings & "D" shackles
Fall of Materials should be used
No oblique pulling to be with
Hit by hydra to men hydra
& materials No man & material will stand
with in movement area of hydra
 Proper guards will be provided
for front & rear wheel to avoid
accident
Store room of Oxygen & fuel
cylinders will be provided
Oxygen cylinders should not
Hit by crane to fuel kept with in crane movement
n& oxygen cylinders area
Fitness proof vehicles will be
provided for work
Failing of crane VT trainer person will be
brakes engaged for operating crane
Foreman will be provided for
supervision which lifting of
materials within 40 mts in
Hydra operation fabrication yard
suddenly stopped in After unloading the lifting
load lifting & material crane operation will be
shifting condition stopped
Minimum 6m distance to be
maintain from crane working
zone
Hydra should not travel near
Collision of Hydra the crane while working
 EXCAVATION CERTIFICATE
Yellow - Permit Applicant / Holder, Green-Work Site, Blue-Authorizer Copy

1. APPLIED BY PERMIT APPLICANT (Applicant to get clearance from all concerned dept.)

Sign………………………………………… Plant……………………………………… Certificate

… No………….
Name………………………………………
Location…………………………………… Permit
Date………………………………………… No……………..
Equipment………………………………….
2. DETAILS OF EXCAVATION Limits of excavation to be shown on as built drawing attached to this certificate

3. DETAILS OF EXISTING UNDERGROUND SERVICES NEAR EXCAVATION

4. DEPARTMENT APPROVAL (Department to be consulted to be specified by responsible Executive)

I have examined the drawings of the proposed excavation, and of adjacent underground services, I confirm that the
excavation may proceed, subject to any comments noted below.

DEAPARTMENT REMARKS /CONDITION/ OBSERVATION SIGNATURE NAME DATE

TELECOM
ELECTRICAL/
INSTRUMENT
CIVIL
UTILITIES
OTHERS
5. PRECAUTIONS
5.1 Cable detector to be used over proposed route __________________________________________
5.2 Pilot Trenches to be hand dug to locate services. __________________________________________
5.3 Excavation may be carried out by mechanical
means of after pilot trenches are completed, __________________________________________
but no closer than 1 mtr of service.
6. PERMIT AUTHORISER 7. PERMIT HOLDER
I Authorize the excavation work specified above to be carried I understand all the above safety precautions; I will
out, subject to the nominated safety precaution and ensure that work only takes place when all these
conditions being maintained during the validity period of the safety precautions are complied with.
permit(s) to work specified in the certificate

Sign:………………,,,… Name:………………………… Sign:………………,,,… Name:…………………………

Date: ………………… . Time:………………………… Date: ………………… Time:…………………………
 CERTIFICATE FOR CLOSURE OF ROADS
Yellow - Permit Applicant / Holder, Green-Work Site, Blue –Authorizer

Permit No: CERTIFIFCATE No.

A) Plant/Area: ________________________ __________________Equipment Tag No. : ______________________________________

Location of the job: ____________ _____________________________________________________________
Description of the job / reason for closure :_______ ________________________________________________
_______________________________________________________________________________________

Name of the contractor : __________________________________ No. of Workers : ___________________________

B) Precautions Taken ( Tick mark which are applicable, strike out which are not applicable )
Alternate route for the traffic arranged , Please specify __________________________________________

Temporarily barricade using caution tapes.

Physically barricade using pipes/rods

Warning signs installed at 50M, 100M & 150 M (road diversion, men at work, night lamp, etc.)

C) Clearances by other departments

1. Fire department 2. Security department
Alternate route indicated is Alternate route indicated is

Okay Not okay okay Not okay

If not ok, suggestion for alternate route : If not ok, suggestion for alternate route :
-------------------------------------------------------- -------------------------------------------------------

Name Signature Date Time

Fire Dept
Security Dept
D ) Additional precautions / special instructions : ________________________________________________
_____________________________________________________________________________________
E) Authoriser and Applicant : Certify that the precautions are fulfilled, work site, equipment are ready
and safe for the job. Permit is valid upto _________ hrs. on ____________ unless extended as per section F.

Designation Name Signature Date Time

Applicant
Authorized by
Permit Holder

F) Extension of Validity (to be renewed every day. Max. Validity - 7 days).

Conditions checked and the permit is re-validated as under :
Extended by Applicant Accepted by Authorizer Extended up to
Name Signature Name Signature Date Time
Extension 1
Extension 2
Extension 3
Extension 4
Extension 5
Extension 6
G) Job completion and closure of permit: Job is completed and we have inspected the site and found the
Area cleared of men and materials. Permit is hereby closed.
Name Signature Date Time
Applicant
Authoriser
Permit Holder
 RADIOGRAPHY CERTIFICATE
Yellow-Radiological Officer, Green-Work Site Blue-Authorizer Copy
This is not Permit to Work

1. APPLIED BY PERMIT APPLICANT

Sign… Plant………………………………………… Certificate

……………………………………… No………….
Location………………………………………
Name……………………………………… Permit
……………………………………… No……………..
Date…………………………………………
2. REASON FOR RADIOGRAPHY

A. GENERAL INFORMATION:
RADIATION SOURCE :

1. X-RAY APPARATUS: MAKE_________________________

TYPE _________________________

MAX.TUBE VOLTAGE____________KV

2. RADIOACTIVE SUBSTANCE SEALED UNSEALED

TOTAL ACTIVITY_______________HALF LIFE_________________

ISOTOPE_________________________________________________

TYPE OF RADIATION ALPHA BETA GAMMA NEUTRON

B. SPECIAL PRECAUTION TO BE TAKEN:

__________________________________________________________________________________
__________________________________________________________________________________
4. PERMIT HOLDER (Qualified Radiation
3. PERMIT AUTHORISER
Protection Supervisor)
I Authorize the radiography test specified above to be I understand all the above safety precautions; I will ensure
carried out, subject to the nominated safety precaution that work only takes place when all these safety precautions
and conditions being maintained during the validity are complied with.
period of the permit(s) to work specified in the certificate Note: Part A & B to be filled by Radiation Protection
Supervisor only.
Sign:………………,,,… Name:………………………… Sign:………………,,,… Name:…………………………
Date: ………………… . Time:………………………… Date: ………………… Time:…………………………