GAIL (India) Limited

NG Transmission - Noida
COLD WORK PERMIT
CWP
Permit Number: 3074834
Request Number: 2082308
Work clearance from 2:59:22 PM hrs of date Jan 23, 2024 to 5:45:00 PM hrs of date Jan 23, 2024
(valid for the shift unless renewed)
Issued to ( Department / Section / Contractor ): OM-BTI-G(O&M BHATINDA- GENERAL SHIFT)
Exact Location of Work Area / Unit: ?0100000000000023855 - GSPL CGD BATHINDA SKID
Equipment No.: -
Maintenance Order No.: 23041560 Notification No.: 15294409
No. of Persons Involved: 3 JSA No: .................................
Description of Work: NEW GGL SKID COMMISIONING JOB.

THE FOLLOWING ITEMS SHALL BE CHECKED BEFORE ISSUING THE PERMIT

(Tick mark in the appropriate box. Checklist items marked with asterisk (*) shall be complied by receiver)
Code Item Description Done/Not Required Short Text
01 Equipment / Work Area inspected Y inspected
02 Surrounding area checked,cleaned & cover Y checked
03 Equip blinded/disconn/closed/Isolate/wed Y isolated
04 Equipment properly drained,depressurized Y depressurised
05 Equipment electrically isolated, tagged N
06 Equipment water flushed N
07 Equipment properly steamed / purged N
08 Proper ventilation and lighting provided Y provided
09 *Area cordoned off & caution borads/tags N
10 Gas Test : HCs(%LEL) : N
11 Toxic Gas (ppm) N
REM1 Remarks 1 : Y inform C/R
REM2 Remarks 2 : Y USE PROPER PPE'S
REM3 Remarks 3 : N
REM4 Remarks 4 : N
REM5 Remarks 5 : N
Note-1: "Y" for Done and "N" for Not Required

General Remarks:
1) The activity has the following expected residual hazards (Tick the relevant items): Lack of Oxygen/ H2S, Toxic Gases/
Combustible gases/ Pyrophoric Iron/ Corrosive Chemicals/ Steam- Condensate/ Others
2) Following additional PPE to be used in addition to standards PPE (Helmet, Safety Shoes, Hand gloves, Boiler suit): Face
Shield/ Apron/ Goggles/ Dust Respirator/ Fresh Air Mask/ Lifeline/ Safety Belt/ Airline/ Ear muff etc.
3) Additional Precaution if any:
* PPEs to be used & SWP/SOP to be followed.
* Proper job supervision to be ensured.
* Area operator/ engineer to be informed.
* Non- sparking tools to be used.

Issuer Name & Designation Signature Receiver Name & Designation Signature
ANIL SHARMA(15905), SR MANAGER ANUJ BHARDWAJ(17334), SR FOREMAN
(O&M-NG P/L) (ELECTRICAL)

Permit Number 3074834

Page 1 of 2 Request Number 2082308
 Work Permit Closure Details
Receiver: Certified that the subject work has been Issuer: verified that the job has been completed and area
completed/ stopped and area cleared cleared and is safe from any hazard

Date & Time Name & Designation Signature Date & Time Name & Designation Signature

Permit Renewal Details / Clearance Renewal

Reason for Extension /
Date From Time To Time Additional Precautions Issuer Name Signature Receiver Name Signature

General Instructions:
1) The work permit shall be filled up carefully and accurately in clear handwriting ensuring that complete information is
provided in all the sections/subsections. Sketches should be provided wherever possible to avoid miscommunication.
2) Appropriate safe guards and required Personnel Protective Equipment (PPEs) shall be determined by a careful analysis of
the potential hazards and the operations to be performed prior to starting the work.
3) Requirement of standby personnel from Process/ Maintenance/ Contractor/ Fire/ Safety etc if any shall be mentioned in the
additional requirement.
4) In case of fire alarm/ siren, all work must immediately be stopped.
5) For renewal of work clearance, the issuer shall ensure that the conditions are satisfactory for the work to continue. If the
conditions have changed, it may be necessary to issue a new permit or amend the existing permit.
6) This clearance on the same permit can be renewed/ extended up to a maximum of seven calendar days.
7) This permit must be available at work site at all times.
8) On completion of the work, the permit shall be closed.

Details of Jobs as per Work Clearance Application:

NIL
Details of Jobs as per Work Clearance Document:
NIL

Permit Number 3074834

Page 2 of 2 Request Number 2082308