Tanker Safe Work Permit No Date of Issue

Tanker Berth User / Business Unit Location of Job

Validity Period Gas Free Revalidation

Issuing Performing
Day
Authority Authority 0-3 3-6 6-9 9-12
From To
hrs. hrs. hrs. hrs.
Date Date
Day
Time Time
1
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
2
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
3
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
4
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
5
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
6
Night Date Date
(if any
work) Time Time
Date Date
Day
Time Time
7
Night Date Date
(if any
work) Time Time

Rules for Renewal Sheet

1. Tanker Berth Safe Work Permit shall be renewed by the Tanker Berth User or Business Unit (as mentioned on the permit) representatives (Issuing Authority and Performing Authority) for 7 days
starting from the date and time of issuance. Renewal shall be done every 12 hours (Day and Night) even if no work is been carried out.
2. If the permit involves Hot Work, Confined Space Entry and Vehicle Entry, The Gas Free readings shall be revalidated by EHS Approved Gas Tester every 3 hours from the date and time of
issuance.
3. Tanker Berth Safe Work Permit shall be invalid if the Renewal Sheet is not signed, The Safe Work Permit and Attached Renewal Sheet Must Be Cancelled by the Issuing Authority.
4. Only After All Safety Checks, Including Gas/Oxygen Measurement (If Applicable), are Carried Out and Authorized Personnel Signature are Obtained in The Respective Columns, The Work shall
be permitted to commence.
5. All Precautions and Requirements, As Stated in Original Safe Work Permit, Remain Valid and Shall Be Followed.
6. The Issuing Authority shall be responsible for the renewal of the TBSWP on Daily Basis.