93.M FOR E.P.

C CONTRACT OF NEW ADMINISTRATIVE CAPITAL CITY MONORAIL AND 6TH OF OCTOBER CITY MONORAIL

Main PTW
Request No (office use only)
(Will be used in EHS permits) Date: Entity: GILA

Cutting cable tray

Brief Description of Work to Be
Carried Out

Location (include Level, Zone,

Room Number as applicable)

93M.0300..B15.OOOPW.MOS.00001
Supporting Document Ref.
(Method Statement, risk
assessment, workers list, etc.)

Safety Permits required □Cold work □ Hot Work □ WAP

□ Confined Space □ Lifting Permit □ SWAP
No activity will be commenced on □ Working at Height □ Manlift permit
site without approved EHS PTW □ Electrical Permit □ Night/Out of hours working

Permit Requested From (Date) From: To: Time: From: 8:00Am To: 5:00Pm

PIC (person in charge) Name: Mob. No.:

Name: Date:
Permit Requester
Signature:
Name: Date:
Alstom Job Supervisor/Installation
representative Signature:

Name: Date:
Alstom EHS representative
Signature:
Name: Date:
OPC PTW approval Signature:

OPC permits is an access approval to the working area and you still
required to obtain all related permits approval prior to start the work
 93.M FOR E.P.C CONTRACT OF NEW ADMINISTRATIVE CAPITAL CITY MONORAIL AND 6TH OF OCTOBER CITY MONORAIL

(Completion / Cancellation)
I hereby certify that the works detailed in Part 1 have been:

☐ COMPLETED and the Permit is no longer required. All tools, equipment and materials have been removed from the work area and
stored in the designated locations. The work area has been left in a safe condition. A joint inspection by the relevant entities of this
permit has taken place and any damage and / or remedial works have been recorded.

☐ CANCELLED / SUSPENDED (Delete as appropriate) for the reasons listed below. All tools, equipment and materials have
been removed from the work area and stored in the designated locations. The work area has been left in a safe condition. All
site staff relating to this permit have left the area.

Reason(s) for suspension / cancellation

AT/Contractor Person in Name: Date:

Charge (PIC)
Signature:

Job Supervisor/Installation Name: Date:

representative
Signature:

EHS representative Name: Date:

Signature: