Permit No.

& Date
LOADING UNLOADING PERMIT
Project & Unit: Emergency Contact Nos
HSEP:12-F09 Agency:

Exact Location of Work: _________________________________________________________________________________________________

Nature / Description of Work:
Duration of Work Execution *: From Date: to Date: ____Daily from ______________ hrs. to ___________hrs.
Name of Agency Performing the Work:
Name of Agency’s Site Engineer (Permit Requesting Authority): Sign:
Name of Agency’s Package In-charge: Sign: Date:
The above described work will be done under all the safety precautions mentioned on this permit to work as under during the currency of the Permit.
Not required /
No. Item Yes Remarks
1. Sufficient Area has been provided for material unloading
2. Material loaded properly / Safety precautions taken – Unlashing can be undertaken. (In case loosening the
material lashes could lead to material falling in uncontrolled manner)
3. Loading / Unloading Cranes, T&Ps are in order with valid TPI certificate.
4. Workers involved are properly trained and sensitized to the dangers
5. Crane operator is authorized and experienced Rigger is available
6. Communication methodology between different gangs is in place. Communication gear (walkie-talkie sets etc.)
provided where required
7. Adequate supervision is in order
8. Area barricaded including backside movement of crane.
9. Emergency response team & Medical Facilities available.
10. Work hazards are identified, controlled and communicated to the worker in daily Safety PEP talks.
11. Method Statements/ Job Safety Analyses attached:

12. Other:

13. List of Other Permits Required for the Activity (Attached):

(To be printed on both sides of an A4 Sheet)

14. Toolbox Talk Records with (preferably) list of workers involved in the Permit Activity (to be attached)

The conditions mentioned in the above checklist are sufficient for safe completion of this activity. These have been checked and found complied before issuing the
Permit, and shall be monitored and ensured throughout the currency of this Permit.
A. Permit Requester/ Receiver (Agency):
Site Engineer: Site HSE Officer:
Signature: Signature:
Name: Designation: Name: Designation:
B. Permit Issuer (BHEL):
Site Engineer/ Authorized Representative: Site HSE Officer/ Authorized Representative:
Signature: Signature:
Name: Designation: Name: Designation:
C. Package-in-charge (BHEL):
Signature:
Name: Designation:
(* Permit valid for 14 days as per overleaf format)
Original: Permittee 2 nd Copy: Agency Deptt. HOS 3rd Copy: BHEL Site HSE

P.T.O. Page 1 of 2
Bharat Heavy Electricals Limited, Power Sector
 Permit No. & Date:
All parameters from S.No. 1 to 14 on Page 1 of this Permit are to be checked physically. In case any deviation is observed, same is to be
rectified, only then work is to be started
Daily Work Area Condition Endorsement
Remarks (if any) & Signature with Date & Time
Day Date Agency Site Engineer Agency HSE Officer BHEL Site Engineer BHEL HSE Remarks
* Officer *
2

10

11

12

13
14

Permit Extension Beyond Initially Requested Hours

Extension Period Signature with Date & Time
Sl. No. From……. To…… Remarks Agency Site Agency HSE BHEL Site Engineer * BHEL HSE Officer*
(Date, Time) (Date, Time) Engineer Officer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Permit Closure After Work Completion
Permit is here by returned after completing the job, ensuring safe removal of men and material and proper housekeeping of the Area.

Reason for Closure: Job complete Permit Validity Over

Agency
Site Engineer Site HSE Officer
Signature: Signature:
Name: Name:
BHEL
Verified as above and Permit is Closed In case job not complete, New Permit No. Issued:
Site HSE Officer* Site Engineer*
Signature: Signature:
Name: Name:
(* or authorized representative duly concurred by Region HSE)
Bharat Heavy Electricals Limited, Power Sector Page 2 of 2