V3

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CONSTRUCTION PTE LTD
Doc No: V3-OHS-810-1-F08

| Operational Control 01 Jun 2021 Rev. 0

GENERAL WORK PERMIT

Start End
Date Time
Approval (stage 4) PermitNo V3/Myra/G
This permit is valid for one day only. The conditions of issue must be complied with throughout the duration of work. The permit may be
withdrawn at any time. Applicant is responsible for the copy of this permit and must be produced upon request and returned to the Safety
Dept upon completion ofwork.
Location ofWork Myra
Description of Process &Work Activity
Equipment/ Machinery Used

The following measures must be observedl complied with before the start of any work.
(Tickwhere necessary andindicate N.A when notrequired.)
Workers have been briefed on Risk Assessment, Safe Work All floor opening and open sides have been adequately
Procedures barricaded
All works are within a working height of 2metres All electricaltools have been inspected by LEW
Daily Toolbox Meeting have been conducted Warning signs and barricade have been placed at work
area
Workers are provided with required PPE
Note: a. I hereby seek approval to perfom the above work
b.I have taken measures to render the place safe and I shall ensure compliance with the instruction as stated.
C.Any changein condition willinvalidatethis Permit and anew Permitwillbe applied wheneverthe existing Permitis invalidated
Stage 1:Application of General Permit-To-Work To becompleted by Applicant
I have read he conditions relating to the work to be performed and I fully understand the nature of work required and will ensure that the above measures are fully complied
with.
Name of Applicant Signature
Designation Appointed PTW applicant Company
Date Time
Stage 2:Inspection &Endorsement (Tobe completed by V3 AreaIn Charge
I have inspected and assessedtogether withthe applicant on the worklarea to be performed andcertifiedthatall measures arecomplied with
Name Signature
Designation Appointed Area Incharge Company V3 Construction Pte Ltd
Date Time
Stage 3: Check &Confirmation (To be completed by Contractor PTW Assessor)
I have checked and confirmthattheworkissafeto proceed.
Name Signature
Designation Appointed PTW Assessor Company (Contractor)
Date Time
Stage 3: Check &Confirmation (Tobecompletedby V3Construction P/L PTW Assessor
Name Mr.Anand/Sakthivel Signature
Designation Appointed PTW Assessor Company
Date Time
Stage 4:ApprovalofPermit(Tobe completedbyV3ConstructionP/LHOP Or his Designates)
Name Mr. Cui Yongjie_ Signature
Designation Project Manager/Authorized Manager|Company V3 Construction Pte Ltd
Date Time
Stage 5: Completion of GENERAL Work To be completed by Applicant (Site supervisor)
Theabove work has been completed on at hrs andI hereby return this permitfor yourretention.
Name of Applicant Signature
Designation Appointed PTW Assessor Company
|Date Time
V3
Page I of 2
CONSTRUCTION PTE LTD Doc No: V3-OHS-810-1-F08

Rev. 0
Operational Control 03 Jan 2020

GENERA L WORK PERMIT

Notes onusageof Permit to Work (PTW) Format

(1) PTW is Compulsory for hazardous works as follows:
() Any hazardous Work activities as specified by the WSH (Construction /Work At Height)
Regulations, Code of Practicel Workplace Safety and Health Officer/ Coordinator
Committeel Head of Project or his Designates

(2) GENERAL PTW application procedure

() Project/Location of Work shall be identified with indication in site layout map/drawing.
(ii) Description of work shall be in accordance to risk assessment and verified.
(iv) Equipment machinery used shall only be in relation to General works that does notfalls o
classifed under hazardous work. Statutory certificates and daily checklist of machinery
used must be made available during PTW application when applicable
(v) Stage 1-GENERAL permit shall only be applied by the supervisor whom is appointed. He
She shall be minimum supervisor construction safety or equivalent trained.
(vi) Stage 2- GENERAL permit shall only be endorsed by the respective site in-charge whoom
s appointed and ensuring site is safe for works. He/She shall be minimum supervisor
construction safety or equivalent trained.
Pte Ltd/contractor
(vii) Stage 3- GENERAL permit shall only be endorsed by V3 Construction
site is safe. He/She shall be minimum
safety assessor after inspection and confirming
supervisor construction safety or equivalent trained.
Head of Project or his
(vii) Stage 4- No work shall start until the PTW is Approved by
Designates.
(ix) Stage 5- Completion of work at height To be completed by Applicant (Appointed
supervisor)
contain the Hazards
(3) In preparing the PTW, the hazardous Activity and the Control Measures to
must be adequately stated in the PTW Format.

be shown upon demand for inspection

(4) PTW upon approval, must be displayed at permit box or to
Committee/ Head of Project or his
by Workplace Safety and Health Officer/ Coordinator/
Designates.
(5) All control measures stated in the PTW shall be Fully complied with at all times.

in work activity or incompatible works must be report by site supervisor immediately

(6) Any changes
to HOD/Safety Dept.

(7) Subcontractor or relevant personnel where PTW is applicable, shall verify the hazards are

PTW shall be applied if new hazards are present due

unchanged during the validity period. New and equipment etc. Please consult the
to changes in conditions of works/personnel/plant
Coordinator or his Designates when in doubt.
Workplace Safety and Health Officer or
 PERMIT TO WORK NO:

VOperational Control
CONSTRUCTION PTE LTD Doc No:V3-OHS-810-1-F-21

03 Jan 2020 Rev.0

DAILY SAFETY ASESSOR PTW CHECKLIST (SUBCON)

Name Contractor *

NRIC/FIN no Designation
Location
Date (Circle/ indicate where applicable)
Inspectioon
General PTW
Housekeeping maintained at work areas? YININ.A
1 YININ.A
2 Proper and safe access egress provided at work areas7 YININA
3 All works less than 2 meter in hejght? YININ.A
4 Electrical tools safe and inspected by LEW YININ.A
5 Workers involved briefed on RA /SW related to activity?. YININ.A
6Hacking Locations cleaned of debris?(indicate locations)
WAH PTW YININ.A
sides and
Guardrails are in place to prevent person from falling thru
opening? YININ.A
2 No incompatible works below? YIN/IN.A
3 Valid certs,checklist for use of MEWP? YININ.A
4 Valid inspection tags and checklistfor scaffold ? YIN/NA
5Provision of anchorage points whereby guardrailsis not provided? YININA
6 Workers involved Trained &briefed on RA/SWP related to activity? YININ.A
Removal of safety provision to facilitate works
assessment)
eg guardrails, toeboard ? (indicate locations and risk
Hotwork PTW YININ.A wa*

Area free of combustible materials? YININ.A

Hot work equipment in good conditions?
Fire watchman pravided?
* *

YIN/N.A_
YININ.A
Suitable Fire-fighting equipment provided? YININ.A
5 Workers involved briefed on RA/SWP related to activity?.
Others YININ.A
Competent assessor appointed for WAH and or other activity? YININ.A
RA adeguate and relevant to the work process?_ **

YININ.A
Immediate supervision compliannce for relevant activity?
V3 rectified? YININ.A
4 Are all safety inspections on the previous day by
reference number sent for
indicate number of inspection finding and (No:
closure)?2 YININ.A
previous day?
Any pending safety inspection finding fromremarks
and state reason under for consideration)
indicate number (No:
* * * * * * * * * * * * * *

Remarks5
Special instructions by V3 Safety department:

Acknowledged and responsible for implementation by

Name &Sign
with the instruction as stated.
Thave taken measures to render the place safe and I shal ensure complianca whenever the existing Permit is irivalidated
and a new Pemmit will be applied
change in condition will invalidate this Permit
Any
PTM is applicable, shall verify the hazards are unchanged during the validity period.
Subcontractor cw relevant personnel where **