Form No / REV No F/PA/20, 00
WORK PERMIT FOR CONSTRUCTION
Porcedure No SPR-02
WORK
Effec. Date 15.02.2014
Put wherever Applicable
This permit is Mandatory for all contractors such as All types of construction work
New permit Permit extension Permit No.
Location of Work :
Permit Issue Date and Time :
Contractor's Name :
No of employees : Permit Closing date and Time
Nature of work :
Identify the hazards & risks in the work ( Write Yes/ No )Safety Checks/Guide line for this particular work
Risk of falling from height : Area is cordoned off properly
At height work scaffold should be
Foot injuries possible:
used
Ensure there will be no electrical
Chance of eye injuries
live cables/ loose cables.
At the time of slab two access
Hand injuries possible:
should be defined
At height work full body harness
Body Injury
should be used
Precaution to be taken at the time
Chances of Electrical shock
carpentry work.
PPE for this particular work
Safety Helmet Safety goggles
Hand gloves Safety shoes
Full body harness with two
lanyards
1 Is the risk & hazards explained to contractor
2 Is the emergency response plan made known to contractor
3 Is the EHS requirements made known to contractor
4 Availability of fire extinguishers ; first aid boxes made known to contractor.
Declaration by the contractor
I have understood the EHS requirement of EPPL, I will follow the instruction given to me and I will take the responsibility to safe working
in EPPL site.
Contractor : Permit initiated by : Dept Head EHS / HR Dept.
Permit closing
After Completion of work permit should be closed
I certify that I have completed the work specified in this permit. All my workmen and equipment have been removed from vicinity of the
above work and all genrated waste are disposed in proper manner as per hazardous waste rule
Contractor : Permit initiator Dept Head EHS / HR Dept.