HSE Department customer company name NITY vam Responsible person in attendance/Company name Fujairah Oil Tanker Terminal ]Vaitty period: From, sits 20 Hous, ate ela aoe Hours, pce toe bos be {each raring suse aad Re Fs aying t rien i Safe Work Permit Customer CDL-o2)_ perme” ade Furman worthy a continuous Gas? Quygen monitoring with auch visual alarm in place | Hazards from routine/ non-routine operations: considered and concerned persons ae alerted. Equipment isolate from mative power: _|_fecriciey/ ar water and tagged srisk assessment evaluated and risk foctor within acceptable evel and communicated to concern personas “T"area cordoned of /bariaded Surrounding ares checked, Cleaned vp, oi ragy/combuvible materia ete removed and made sae. Emergency procedure explained and understood by all concerned. ‘Charged Wvewater ova/portable fre | extinguishers provides Fire water system checked for readiness Adjacent orains/vents, manholes and other sounding surfaces covered and made af "Temp. Hamidi, Ai welocly within safe [permissible ints. [Al tools/equipment are safe and in good working condition PE: har hat, safety shoes, coveral Rulbody hhamess, safety spectacles forall and wolder's PPE etc. provide. Werk area/equipment in Suitable communication system established ‘among terminal and performing authority rovised arc testes “Adequate llumination Torte ob and for | 7 sigan Mobile crane postoned and out rggers | ‘extended fully and placeé on hard board and area barricades with warning sgn ‘Warning signs/precautionary tags/ safety board's provided at prominent paces. Proper work patform/accass/ emergency exits provided Fixed/portable equipment grounded in appropriate manner Shield against sparks provided and ition hazards contained. | —>t Ae ali tet erie veto a ng equipments /loose gears? ao (sa erecin sn appa Hae? Ts seafiolddsmarting in an appropiate manner? is sultabie and suficiont sae access and egress | inplace 'Noncombustible fre blanket provided to contain sparks. ‘Does fall protection consist of ether pesonalFujairah Oil Tanker Terminal Safe Work Permit HSE Department Customer ‘Special condition/precautions/attachment 'Name/signatureof Safety personal appointed tse —"\ "Gy ee Name signature fang Fire watchat st 392 WO MOWED NCE Dp ce fe urnrEe "have inspected the location of work anc ts safe to start the hot work als worn/ working theghtin the encosed/open space as per approved hs aTRA. Thave verified al work perm condone ad tf sete to commence the Jom of Performing Author ‘Name of the company FOTT-Operation Department Peeper ger performing the task. obs stopped/ completed and men, materiel & machinery ae withdrawn, jb site = cleed afd permit may be eanecheg Verified by Performing Authority The Job i stopped/ completed and considered safe ana Work perm is cancaled Name & Signature of FOTTFujairan Un tanker terminal (rut t) H.S.E Dept. ate work Hermit Customer ares: _EOTT oT 2 touyesre:_OT 2 venice Validity period: From O of -OD Hours, one Hh) os} gle To:_19. 0% Hours, Location of work Description of the job: ‘Safety taik/t00i box taik conducted aiards fom routine] non-Tovtine operations considered and concerned persons are alerted ‘Work area has been gas fee and made human worthy and continuous Gas/ Oxygen monitoring with usio visual lam is paced. ‘Suitable communication system among persons | 7 in confined spae/ attendant ofthe entey/terminal provided and tested. Isrsk assessment evaluated and risk TaGo within acceptable level and communicated to concern personas "Men & material to confined /enciosed space” entry monitored eepultes Emergency procedure explained and understood by al concerned. is confined spce erry rescoeeaupment standby. a i proper protective shoring provided by concrete Bock work te ‘avoid and side or collapse of si? ‘Sutable continuous eectve ventlation of provided fr confined/enciosed spaces. is making slopes or benching around the periphery of the ple area are according tothe regulations. ‘eaten Tre ator emergency x Ts Reavy eauipment near the excavation area avoided by bavricacing the ares? Ts de-watering syste operational? 's appropriate signage provid atthe excavated area? 7\ soil spill drip control system from the vehicles in place ‘Work area/equipment inspected and made ae, ‘Temp. , Humid, Al weiody within safe permissible its, ‘Waring/precautonary tags/ safety bowd's provided at ‘prominent places Vehicles ae in ood operation condition nd ‘competency of driver /operator/igger/fgmen venes? Proper work platform/access/ emergency eats provided. ‘Are vehicles exhaust pipes protected by spark avest muffers? Fxed/portabie equipment grounded n appropriate manner Vehicles revolving lights /ndiator are operational and speed imit maintained 206m /hr | coriates aren place ‘Vehicles valid registration and third party Proper design of shoringif excavation area exceeds more than 12m, \s suitable and sufficient safe access and egress provided? Benching or sloping of soll at an angle 1: ato. FOTT/HSE/002/12 PEs ara hat safety shoes, Coverall safey pectacies A, Aine line et. Provides.Customer rujairan Uu tanker 1erminat (rutt) Sate work Permit f H.S.E Dept. Special condition/precautions/attachment Thave verfieg allwork perm conditions and iti safe to commence Me JOO ani kata. “ri bens, Bee tiered —neueias Name & Signature of Performing Authority ‘Name ofthe company Name & Signature earns ofthe company Date tim fobs stopped/ completed and men, material & machinery are withdrawn, jo ste sceaned and permit may be canceled, Veiled by Performing Authority ate, Time enennnnn The lb is stopped) competed and considered safe and Work perm canceled ame & Signature of FOTT Duty Sup RULES FOR ISSUANCE OF SAFE WORK PERMIT FOTT/HSE/002/12