SSD-EHS-07-2018/010
Salarpuria Sattva Developers Pvt Ltd
Extended Working Hours / Weekend, Holiday Working Approval
Project Name : Date : Time :
Company requesting the Permit : Pemit No:
Extended working hours :
From Date:…………….. Time:……AM/PM
Description of work : To Date:…………….. Time:………..AM/PM
Total Number of workmen :
Project Manager of contractor : Name :_____________________________
Contact Number:_____________________ Project Manager of PMC : Name :_____________________________
Contact Number:_____________________
Contractor EHS Cordinatores: Name :_____________________________
Contact Number:_____________________ PMC EHS Cordinatores: Name :_____________________________
Contact Number:_____________________
Description of Operations / tasks:
Mention list of work permits issued for work at height, hot, confined space, excavation, electrical etc.,
Details of permits and activity Details of permit and activity
1 6
2 7
3 8
4 9
5 10
Details of Contactor Personnel in Attendance: ( Activity wise Staff Details with contact Number)
1. Name:_______________________________ Contact Number:__________________________________
2. Name:_______________________________ Contact Number:__________________________________
3. Name:_______________________________ Contact Number:__________________________________
4. Name:_______________________________ Contact Number:__________________________________
5. Name:_______________________________ Contact Number:__________________________________
6. Name:_______________________________ Contact Number:__________________________________
7. Name:_______________________________ Contact Number:__________________________________
8. Name:_______________________________ Contact Number:__________________________________
9. Name:_______________________________ Contact Number:__________________________________
10.Name:_______________________________ Contact Number:__________________________________
Details of PMC Personal in attendance:
1. Name:_______________________________ Contact Number:__________________________________
2. Name:_______________________________ Contact Number:__________________________________
3. Name:_______________________________ Contact Number:__________________________________
4. Name:_______________________________ Contact Number:__________________________________
Details of Sattva Personal in attendance :
1. Name:_______________________________ Contact Number:__________________________________
2. Name:_______________________________ Contact Number:__________________________________
Details of First Aiders-Nurse on shift.
Name: Contact Number:
Contractor Project Manager :
Name: Signature: Date:
PMC Team EHS Cordinatores :
Name: Signature: Date:
Project Manager sign off (Sattva):
Name: Signature: Date:
Job specific PTW should be followed and the copy of permit needs to be attached with this permit while handing over to the EHS cordinator
A copy of this permit is to be kept with the supervisor in charge at all times
To be returned to the EHS Coordinator after the completion of the work.
