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L019 - OHSE Shaft Work Permit Format

This shaft work permit outlines safety precautions for work in a shaft at the Syngene 1401 project location. It requires that all personnel wear proper PPE, receive safety briefings, and have safe access and a work platform. Fire extinguishers and shaft barricades are also required. The permit lists workers entering the shaft and confirms required precautions have been taken. It is valid only for the specified date, time, and location and a separate permit is needed for each shaft.

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Rajib Mondal
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836 views1 page

L019 - OHSE Shaft Work Permit Format

This shaft work permit outlines safety precautions for work in a shaft at the Syngene 1401 project location. It requires that all personnel wear proper PPE, receive safety briefings, and have safe access and a work platform. Fire extinguishers and shaft barricades are also required. The permit lists workers entering the shaft and confirms required precautions have been taken. It is valid only for the specified date, time, and location and a separate permit is needed for each shaft.

Uploaded by

Rajib Mondal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Shaft Work Permit

Shaft Work Permit

Location PROJECT : Syngene 1401 PERMIT NO :

CLIENT : Syngene International Ltd. START DATE & TIME :

PMC : CBRE South Asia Pvt. Ltd. COMPLETION DATE & TIME:

CONTRACTOR :

JOB DESCRIPTION :

LOCATION/AREA :

SHAFT NO :

TASK TO BE PERFORMED:

INSPECTION CONDUCTED:

Safety Precautions required:

No Item Yes Not required


1 All personnel are wearing proper PPE
2 Workers have been briefed about hazards
3 Safe access to shaft available
4 Safe working platform erected
6 Fire extinguisher provided for hot work
7 Shaft appropriately barricaded
8 Confined space rules in place

Names of workmen entering shaft:

I have ensured that the safety precautions as listed above for the task to be performed have been taken for this shaft
work

_____________________ ______________ ____________


Name of Permitee Signature of Permitee Designation

_____________________ ______________ ____________


Name of Issuing authority Signature of Issuing authority Designation

Notes:
a) Separate permit required for work in each shaft

b) Work permit is valid for the prescribed date, time and in prescribed location only

Date & Time: Permit is closed


Name and Signature of the Issuing authority:
CBRE South Asia Pvt. Ltd Project Management India Page 1 of 1
Format No. L019-OHS-SP-Fr-019/Rev01/Oct2013

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