PERMIT TO WORK

Permit Title Permit Number

RIGGING RAZOR WIRE 011/19
Job Location
MAIN DECK PORT & STBD , POOP DECK.

Equipment to be worked on
RAZOR WIRE, CUTTER

Description of work to be done and it's limitations

RIGGING RAZOR WIRE

Hazard identification - include hazards introduced by the work and residual hazards
SLIP SHARP EDGE CUTTING
TRIP
FALL

Precautions necessary to be taken, who does them, what signs required

Precautions Who puts them in place What signs required
WEAR PROPER PPE C/O N/A
SITUATIONAL AWARNESS C/O N/A
WEAR SAFETY HARNESS

What protective equipment is needed

Personal Protective Equipment Other Protective measures
Safety Shoes Safety Harness SITUATIONAL AWARENESS
Safety Helmet
Safety Gloves
Boiler Suits

Authorisation
Name DHIRAJ P YADAV Date of Permit 14.06.2019
Signature
Time Duration of Permit 08:00 - 18:00
Acceptance
Name BOSUN / AB RAJKUMAR / AB TANDEL / AB FERNANDES / OS
Signature

Extending the Permit to Work / Handing Over

Name N/A Date N/A
Signature
New Expiry Time of Permit
Handback
Permit Worker Permit Issuer
Name BOSUN Name DHIRAJ P YADAV
Signature Signature

Cancellation
Name C/O DHIRAJ P YADAV Date 14.06.2019

Version 00/ 01 Dec 09 1 of 1 Form Deck 18

Boiler Suits
Barrier Cream
Chemical Suit
Dust Mask
Gas Meter
Safety Gloves
Goggles
Oxygen Meter
Respirator
Rubber Boots
Rubber Gloves
Safety Harness
Safety Helmet
Welding Cape
Welding Gauntlets
Safety Shoes