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Haramain High Speed Railway/Phase 1- Package - 2 / Madinah Station

Employer Engineer Contractor

WORK ASSESSMENT FORM FOR WORK PERMIT

Request No. : 29 Request Date : 9-Jan-21

Work Description: Sand trap repair works

Work Location: HHR Madina Station

Work Schedule/Duration : Start Date: 20-01-2021 End Date: 01-02-2021

Work Assigned to : Yapi Merkezi co.

Yapi Merkezi Safety Contact


Orhan Sönmez - 0582 624 742
No.:

Documents Attached :

Sl. No. Description Yes No N/A Reference No. Remarks

1 Drawing ü

2 Pre-Qualification ü

3 Material Approval ü

Method of Statement/Work
4
Procedure ü

5 Risk Assessment ü

6 Defect list ref list/Completion Form ü

7 Defect List Photos ü

8 Iqama Copies ü

Comments/Feedback if any :

Requested By : Approved By :

Kerimcan Sezek
(Project Manager- Yapi Merkezi)

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