Karot Hydropower Project

BATCHING PLANT PERMIT TO WORK NO.

WORK DETAIL
SPECIAL TOOLS TO BE USED

Issue Date Time

Validity Date Time
Do not proceed with your work until your permit has been authorised by the relevant member of staff.
HAZARDS AND PRECAUTIONS TO BE TAKEN
PRIMARY HAZARDS - fumes, eletics, liquids, sludge, moving parts
PLEASE ANSWER THE FOLLOWING QUESTIONS TRUTFULLY YES NO
Moving hopper & its rollers are in good working conditions.
Conveyor belt is completely segregated.
Islolation of Plant.
Operator having good visibilitly.
Condition of all the hoppers and protection wall.
Warning signs attached.
Has the confined space been electrically isolated and locked out ?
Is the confined space below 30 Dgree C on full cooling ?
Is a supply of respirable air assured / ventilation required ?
Is there an acceptable means of access to and escape from the confined space ?
Are there adequate emergency arrangements in place ?
Is a safety line / tripod / harness and any other back-up equipment to hand ?
Is all CCTV camra are in working condition.
lighting checks of all the units.
Bell warning signal is in working condition.
Emergency stop switch is in working condition.
Check fire extinguisher condition and location.
TIME OF TEST 1 RESULT TIME OF TEST 2 RESULT
OXYGEN PASS / FAIL OXYGEN PASS / FAIL
HYDORGEN SULFIDE PASS / FAIL HYDORGEN SULFIDE PASS / FAIL
CARBON MONOXIDE % PASS / FAIL CARBON MONOXIDE PASS / FAIL
COMBUSTIBLE GASES (LEL) % PASS / FAIL COMBUSTIBLE GASES (LEL) PASS / FAIL

Other Precaution Required

Other Safety Equipment Required
AUTHORISATION AND ACCEPTANCE
I confirm that I have verified the above information and ensured that the necessary precautions have been
taken. It is safe to carry out the work as defined above and the permit information has been explained to all
workers involved. I accept responsiblility for this work.
Permit Requester name Signature
Issuing Authorising name Signature
HSE Representative name Signature
HSE Manager name Signature
COMPLETION OR CANCELLATION
I confirm that the work has been completed / partially completed *, checked by my self and the area left in
a safe and tidy condition. (*delete as appropriate)
Permit Requester name Signature
Issuing Authorising
name Signature
HSE Representative
name Signature
THIS PERMIT IS ONLY VAILD WHEN ALL SECTIONS ARE COMPELTE.