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  • Sapura-CYUS Permit Apllication Form 10.09.20

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    haidhirfcsb
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    This permit to work document contains: 1) Details of the work request including the name of the contractor, job description, project location, type of work, required personal protective equipment, machinery/equipment to be used, and identified working hazards. 2) Sections for the permit to be requested and approved by SECO project personnel. 3) Sections to document when the job is complete or pending closure, and for signatures of the requestor and approver.

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    Sapura-CYUS Permit Apllication form 10.09.20

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    This permit to work document contains: 1) Details of the work request including the name of the contractor, job description, project location, type of work, required personal protective equipment, machinery/equipment to be used, and identified working hazards. 2) Sections for the permit to be requested and approved by SECO project personnel. 3) Sections to document when the job is complete or pending closure, and for signatures of the requestor and approver.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    5 views2 pages

    Sapura-CYUS Permit Apllication Form 10.09.20

    Uploaded by

    haidhirfcsb
    This permit to work document contains: 1) Details of the work request including the name of the contractor, job description, project location, type of work, required personal protective equipment, machinery/equipment to be used, and identified working hazards. 2) Sections for the permit to be requested and approved by SECO project personnel. 3) Sections to document when the job is complete or pending closure, and for signatures of the requestor and approver.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    Doc. Ref.

    : SECO/SHE/F-002
    Rev. No.: 01
    PERMIT TO WORK Issue Date: 21.10.2019

    PTW #: DATE ISSUED: TIME ISSUED:


    29.03.2021 11.00 am
    SECTION A (Permit Request)
    WORKERS/CONTRACTOR NAME
    FASTCOLL CORPORATION SDN BHD
    JOB DESCRIPTION (detail)
    TEST RUN ECS EQUIPMENT

    PROJECT / LOCATION
    KVMRT SSP Line / Location
    CYBERJAYA STATION (CTER)

    TYPE OF WORK
    Working at height (W.A.H) with checklist Lifting with checklist Equipment Installation
    Hot Work with checklist Elevated Work Excavation (1.5 m >)
    Confined Space with checklist Live Electrical Work Others (please specify):
    PERSONNAL PROTECTIVE EQUIPMENT
    Safety Helmet Safety Shoes / Boots Hi Visibility Vest
    Hand Protection (please specify): Ear Protection(please specify): Fall Protection (please specify):
    Eye Protection (please specify): Respiratory Protection (please specify): Others (please specify): Face Mask
    MACHINERY / EQUIPMENT / PLANT USAGE
    Scaffolding Excavator / Backhoe Air Compressor
    Crane (please specify): Power Tools Generator Set (please specify):
    MEWP(please specify): Hand Tools Other (please specify): LADDER
    WORKING HAZARD
    Working at Height Dust / Fibress (health hazard) Breathing Air
    Floor Opening Electrical Shock Heat (exposure to high temp)
    Electrical Shock Ergonomic (Body Posture) Other (please specify):
    PERMIT REQUESTED BY
    Name Date Signature
    AHMAD SHAH BIN ZAINAL 29.03.2021
    ID:L49748 / 019-3550603

    SECTION B (to be approve by SECO Project Team Engineer / Manager)


    PERMIT APPROVED BY

    Signature PERMIT VALIDITY

    Name Date
    Designation Time
    SECTION C (Permit Closing)
    Job Complete Job Pending Housekeeping
    Equipment / Material Stored Other (please specify): …………………………………………………………………………………………………………………………………...
    Requestor Signature Approval Signature
    (to be approve by SECO Project Team Engineer / Manager)

    Name: Name:
    Date: Date:
    Time: Time:
    Doc. Ref.: SECO/SHE/F-002
    Rev. No.: 01
    PERMIT TO WORK Issue Date: 21.10.2019

    SECTION D
    (FOR SAFETY SECO/PDP/MRT PERSONNEL USE ONLY)

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