SPECIEFIC TASK METHOD STATEMENT

Contractor’s Company Project/ contract

Date of the work scheduled: name number

Facility/Area/Location
SAP Work Order №:
General Work Title:

Equipment Info/№:
 If Applicable: ✔
Type of Permit: CWP. SPWP. HWP.
Type of Certificate: CSEC. EXC. RC. Scaffolding Cert. N/A

Type of Isolation: EIC. MIC. N/A.

 PO & PA confirm that the task will be carried out as per the defined steps in this MS
Permit Originator
/ Performing Authority Name Signature
 IA accepts and endorses steps of work defined in this MS
Issuing Authority Name Signature

 Breck down the job steps:

№ Main steps of the work process Equipment / Tools Required
1

10

11

12
SPECIEFIC TASK METHOD STATEMENT