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Six Flags Qiddiya Project Risk Assessment PTW Number

Excavation Work Permit


Start Date & Time Completion Date & Time Company Location

Rabiah Garden

Day Shift
Work Description:

Night Shift

Precautions
Dimension
Length Width Depth

Stationary petrol or diesel driven equipment


Service Drawing detailing utilities
is not permitted 3m from the edge of
(gas/water/electrical/etc.) available for area –  YES  NO  N/A  YES  NO  N/A
excavation, including stop blocks in vehicle
technical department to provide
in vicinity

Does the excavation interfere with any other Suitable and sufficient access is maintained
 YES  NO  N/A  YES  NO  N/A
works or access at all times.

Owners of utilities, services or transmission


Cat scan competent person and equipment
piping etc. (electrical, telephone, water, and  YES  NO  N/A  YES  NO  N/A
in place prior to excavation of soil
sewer) notified.
Adequacy and availability of all equipment,
including shoring material, signs, barricading &  YES  NO  N/A Confined Space Permit Required?  YES  NO  N/A
machinery

List of authorized PTW requesters for excavations Authorized CAT Scan Operators
Name Contact Number Name Contact Number
1. Eng. Muhammed Fathi -HL (CM) 0504526278 1. Rifkhan - HL 0595312817

2. Eng. Aminullah -HL 0556278048 2. Abdelhaleem Ahamed- HL 0591789044

3. Eng. M.Abdul Basit- HL 0505360541 3. Alsharif Mohamed -SL 057004175

4. Eng. Zahi El- Masri-SL Director 0596977596 4.

5. Eng. Ammar Obeidat-SL CM 0535780560 5.

6. Eng. Josepph Uy Jr-SL Manager 0599530641 6.

7. Eng. Mohamad Alam-SL 0561867590 7.

8. Eng. Mohamad Saddiq-SL 0556759197 8.

Permit Approval
Signed by Name Signature Date & Time Mobile#

Permit Requestor

Production Supervisor

Authorized CAT Scan


HSE Department
Permit Closeout / Cancellation

I confirm that work is completed safely, and the area is in clean & safe condition; Apply √ in the box for permit closure intention
hereby closing the permit for Activity Completion Emergency Non- Compliance

Name Designation Date Time Signature

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SFQ-BAJ-HSE-TEM-060-Rev05

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