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WORK PERMIT

PROJECT : CONTROL #
COMPANY :
DATE START & TIME DATE & TIME TO FINISH
WORK LOCATION : (Tower, area Zone)

NAME OF SUPERVISOR/IN-CHARGE :
DESCRIPTION OF WORK/S : (List of activity at the area)

LIST OF WORKERS WHO WILL PERFORM THE TASKS:


1 6
2 7
3 8
4 9
5 10

SAFETY REQUIREMENTS: (List all the PPE to be used during activity)


1. Hardhat 6. Gloves
2. Safety Vest 7
3. Safety shoes 8
4. Safety Goggles 9
5.Harness 10
Checklist to comply before to proceed the Permit
Good Housekeeping Complete PPE to be use
Preparation of Materials Power tools with Monthly Insp.
Protection for Damage Extension wire with Monthly insp.
Illumination & cable management Safety Precaution
Free from Obstruction Proper Storage of Materials

Prepared By: Prepared By:


(Name and Signature) (VPDC Engr./Arch.)
Checked By: Approved By:
VPDC Safety Marshal (Name and Signature) (Proj. Manager Supervisro/PIC)

Approved By: Noted By:


VPDC Safety Officer (Name and Signature) (Construction Management)

DEPLOYMENT
TOTAL

TOTAL MAN POWER


OVER ALL TOTAL MAN POWER
Floor B GF 1 2 3 4 5 6 7 8 9 10 11 12 14 15 16 TOTAL
Tower A
Tower B
Tower C
Tower D
Tower E
Tower F
AMENITY
Over all Total Man Power

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