Revision Date: Oct-12

COLD WORKS PERMIT

Permit No. :
Part 1: Application - WSH (Construction) Regulation Reg. 13
Date & Time of work: From: To: No. of Workers :
Contractor:
Location:
Type of cold works:
Description of work:

Safety Requirements - WSH(Construction) Regulation Reg. 14 :

a. Risk Assessment carried out & attached h. Fire extingusher provided
b. Safe work procedures available i. Proper personal protective gears used ie. Eyes, face, hands, body protection
c. Workers are briefed on the hazards & corresponding control measures j. Attach SDS if chemicals in used
d. PTW/ Location plan displayed at place of work
e. Equipment isolated/ stored seperately
f. Areas clear of combustible materials & incompatible works
g. Warning signs & safety barriers positioned
Others :

Part 2: Check & Endorsement - WSH (Construction) Regulation Reg. 14

a) I have read & understood this permit & agree to work in accordance with the provisions of the method statement & the safety requirements stated in this permit.

b) I have checked the site & satisfied that reasonably practicable steps will or have been taken to safeguard the safety & health of the working personnel

Responsible Persons Name Date Time Signature

Applicant/ Subcontractor Supervisor

CBRE In-Charge

Part 3: Approval - WSH (Construction) Regulation Reg. 15

a) I am satisfied that proper evaluation of risk & hazards involved c) I am satisfied that all reasonably practicable measures will or have been implemented & enforced

b) I am satisfied that no incompatible works will be carried out d) The working personnels are informed of the hazards & protection counter measures to be taken

Responsible Persons Name Date Time Signature

Department Manager

Part 4: Notice of Closure - WSH (Construction) Regulation Reg. 17

a) Work has completed b) Housekeeping has been carried out c) Work area is safe for other personnel

Responsible Persons Name Date Time Signature

Applicant/ Subcontractor Supervisor

Part 5: Confirmation - WSH (Construction) Regulation Reg. 17

a) Work has completed b) Housekeeping has been carried out c) Work area is safe for other personnel

Responsible Persons Name Date Time Signature

CBRE In-Charge / Department

Manager