You are on page 1of 1

CLEAR Attach Photo

PERSONNEL GATE PASS APPLICATION Here


Al Zour Project
(Blue Background)

Badge ID No: ....


( To be allocated by GFC)

PART - 1 TO BE COMPLETED BY REQUESTOR


Select a Group Select option EPC - Work area to access
TSHJ- 055A FDHJV-055B SPESJ-059 HSSJ-045
PMT PMC EPC New Renewal
Sub Contractor Name ( If applicable)

Duration for Temporary Passes (dd/mm/yy) Requirements: HSE&S Induction Completed:

From: 10-Jul-17
.. Site Driving On Shore

To: 29-Jul-17
. Off Shore Off Shore
DETAILS OF INDIVIDUAL REQUIRING PERSONNEL GATE PASS

Full Name: Karthik Dhayalan


........ Employee No: KD 1790E
.

Job Title: QA QC Welding Engineer/Insp


........ Nationality: Indian
.

Civil ID / Passport Number: L4676479


. Contact No.: 94080198
.

Residence / Work Visa Expiry: 13-Aug-19


. Company Name: Amec FW
.

Driving Licence Expiry: . 0000809


Old Gate Pass No: .

Requested By ( application authorising signatory) - Line Manager Contact #



David Waldrop
............... QA..
QC Manager(PMC) .
( Name/Surname) Designation Signature Date

PART - 2 TO BE COMPLETED BY APPROVER ( Security Dept.)


Approved By ( authorised signatory & stamp ) Contact #

............... .. .
( Name/Surname) Designation Signature Date

PART - 3 TO BE COMPLETED BY PMC GUARD FORCE CONTRACTOR (GFC)


Card Production: Verified:
Badge, ID No: .. Name: .. Date: ...

Expiry Date: .. Signature: . Signature: ...


PART - 4 INSTRUCTIONS
The Following supporting documents must be attached to this applications:

Two new colour full facial blue background photographs (portrait), sized 30mm x 20mm, or 1 copy + Electronic File

Copy of Civil ID, or Passport Copy with valid Kuwait work visa stamp

Copy of Onshore HSE&S Induction Attendance Form

Copy of Kuwait driving License ( as applicable )

Copy of HSSJ Marine Induction Form (as applicable )

Copy of Old gate passes for renewal.

Copy of Contractor / EPC internal ID badge

Personnel Gate Pass Application rev 2a