RT WORK PERMITION

Project : RFCL, Ramagundam Sr. No. :

Name of the work : Date:
Name of site contractor: Job No.:

Location of work:

Source strength :

Cordoned distance (m):

Whether Control Room falls in Radiation Zone: Yes No

Name of Radiography agency: Approved by Owner/ EIL

Number of workers engaged :

(List enclosed with name & gate pass number)
The following item have been checked and ensured by Lead contractor & compliance shall be ensured during currency of the
permit by the Lead contractor and the RT Agency hired by Lead contractor.
SL No. Item description Done
1 Safety regulation as per BARC/AERB ensured while source in use/ in transit & during storage
2 Area cordoned off /safe working platform provided
3 Lighting attunements for working during nights ensured
4 Warning signs / flash lights installed
5 PPE’s used
6 Dosimeters Availability
Additional precautions, if any

Presence of Radiography agency’s BARC/AERB authorized SO: Yes No

Permission is granted.

Permit is valid from (AM/PM) (Date to) (AM/PM)

(Signature of Lead Contractor’s person authorized for RT works) (Signature of permit issuing authority of RFCL)

Name:

Designation:

Date:

Work completed / stopped / area cleared at Hrs of Date

(Signature)
Name & Signature of site contractor: