Proıectare șı execuțıe autostrada de centura bucureștı km 0+000 - km 100+900, lotul 2: km 69+000 - km 85+300 aferent centura sudproıectare

șı execuțıe autostrada de centura bucureștı km 0+000 - km 100+900, lotul 2: km 69+000 - km 85+300 aferent centura su Health and Safety HSE-PR-05-F10
Management Plan
Permit and Follow-Up Form For Overtime Form Page 1 of 1

Number of work permit:

PERMIT AND FOLLOW-UP FORM FOR Hours / date of Permit : From........ to .......... From ..../..../........ to .... /.... / ..........
OVERTIME Work Place: :
Project Name : Specialized Team : Employee Names :
Request Date : Number of Personnel Assigned :
Work Description : Main Equipment :
Department Chief :
Name, Signature
MEASURES TO BE TAKEN FOR OVERTIME Y N NA
1. The personnel shall be informed about the works assigned and working area in details
2. Personal protective equipment shall be checked (helmet, shoes, gloves, protective clothes, phosphoric-bright vest, etc.)
3. During night-shifts, adequate level of lighting shall be provided without any shaded area, fuel reservoirs of lamps hall be made of metal (in case of
lighting with lamps burning liquefied fuel) without leakage and necessary measures shall be taken to avoid over-heating, areas where explosive or
inflammable material are stored or used shall be illuminated by lamps situated in glass housing and reflected light, lamps shall not be refilled nearby any
source of flame or heat, no inflammable material shall be situated 1 m above or 30 cm near the lamps, lamps shall be tightly secured to avoid
overturning, open areas and external roads shall be illuminated at minimum 20 lux level which shall be 50 lux for warehouses, depots and stairs and 100
lux for assembly shops and elevator cabins
4. Hazardous sections shall be defined for the personnel where necessary measures shall be taken (like guard rails)
5. An ambulance shall be made available at all times to transfer any sick or injured personnel to the nearest health institution under the attendance of the
department chief or an assigned personnel
6. Necessary measures shall be taken against fire and fire extinguishers shall be made available at all times
7. Necessary measures shall be taken against flood, if any risk is involved
8. Necessary measures shall be taken at the areas where infrastructural and super structural problems may arise
9. Ending hours for overtime shall be defined
10. Overtime personnel shall be attended by a responsible supervisor
11. A first-aid team shall be made available during the hours overtime
12. ................................
13. ................................
14. ................................

NOTE – 1 Measures specific to each project shall be defined in lines remained blank above.
NOTE – 2 A copy of this permit form shall be kept at the manufacturing area.
Responsible Dept. Staff Project OHS Manager Work Permit Approved/Cancelled by Reason
Name : Name Name
Date : Date Date
Signature : Signature Signature
Y : Yes N: No NA: Not Applicable