CONTRACTOR ACTIVITY APPROVAL FORM

Doc No : 00-QA-155 Effetive Date : * February 2022 Rev No : 02

Contractor :

Project/Job :

Date :

We request you to allow us to execute works in overtime as per detail schedule :

No. Register of Target Finished No. of Man

Area Work Description Starting Time Name of PIC
Permit Time Power

Man Power List

No Names No Names

1 11

2 12

3 13

4 14

5 15

6 16

7 17

8 18

9 19

10 20

Approved Notes :

Approved on condition as noted

Dissapproved as noted

Signature :

Name :

Contractor's Representative FFI's Project PIC

Department/Area's PIC

Name :
Safety Officer's Contractor FFI's SHE Representative