Electricity O&M Directorate

Network Management Division

Operation Planning Section
Application For Work Form
FM.ED/NMD/OPL.01-3
Date: 18-06-2018 Request No:
Location: AL Ghareba Scheme No: ND/11/12/15 Contract No:
Nature and extent of work to be done: To Clear the FAC Civil Snag and AC Maintenance.
Working Area (Feeder / PY/ SS Effected) : Substation GB 0046, GB 0047,GB 0048,GB 0049, GB 0050, GB 0051, GB 0053,
GB 0054, GB 0055, GB 0056, GB 0057, GB 0058, GB 0059, GB 0060, GB 0061 & GB 0065 (16 Substations)

Apparatus required for work: Transformer Switchgear OHL Cable Protection & Control System
DC System Others
Equipment Identification: AC Units, TR & S/S Room

Safety document to be issued: Permit to Work Sanction for Test Limited Access Permit
Primary Earths Required Yes NO at :…………………………………………. Risk of trip Yes No
Additional Earths Require Yes NO at :………………………………………….
Date and Time From To Can the Apparatus be Restored Daily Yes No
of work Date 18/06/2018 Date 28/06/2018 Notice period required for re-energizing in case of Emergency
Time 09:00 Time 16:00 ……….Hrs.

Projects Division :
Work requested by (Competent Person)
Name: Khaled Qasem Date : / / Signature : ……….
Name: Karuppusamy Date : 18/06/2018 Signature :……….
Maintenance/OHL/Cable Section:
Tel: 0555956690 Fax: ………………..
Name: ………………Date : / / Signature :…………
Consultant : Tel : …………….. Testing & Protection Section :
Name: ………………Date : / / Signature :…… ……… Name: ………………Date : / / Signature :…………

Field Operation Engineer (To Confirm Apparatus & Extent of Work, and determine Safety Doc. and Points of Isolation)
Name: ……………………….. Signature: …………………… Date: / /
Consumers affected > 3 min. Yes No Primary Earths at: ……………………………………
VIP affected Yes No ,If Yes confirm pre-approval and fax to EOMD-VIP
Points of Isolation at……………………………………………………………………………………………………………………
Comments: ………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………HV Operation Section Head:……………………

This section to be filled by Network Management Division

Work Approved : Yes No If consumer affected >3; inform CSD-CC &LV

Name: : ……………………………… Signature :… ………………… …Date :… ………… Comments : …………..……………………
…………………………………………………………………………………………………………………………………………………………

Operation Planning Section Head: ……………………………………………………………………………………MF No:

Control Centre Section Comments: …..……………………………………………………………………………

Network Management Division. Fax: 03 -7118117 Control Centre Section Fax. 03 7118003
Customer Services Directorate – Call Centre Fax: 03 – 762 9949
FM.ED/NMD/OPL.01-03 Rev1