PTW/21/12/07

PTW/21/11/10
Permit No: PTW/21/11/04

PERMIT TO WORK
Date Start : 14 /12/ 2021
23/11/21
15/11/2021 Date End: 2122/11/2021
/12/ 2021
29/11/21
Time Start: 8am Time End: 11PM
SECTION 1: FILL UP BY PERSON IN CHARGE OF PROJECT COORDINATOR/HOST- Permit must be submitted at least 3 days before job commencement.
Host Name Mohamad Sufi Host Contact No 0127175659 Department ME
Company Name (Contractor) ECMT
Work Area/Location
Furnace Supervisor/Leader Name Melle Jean Louis
Number of Workers 2 Vendor Contact Number +65 96258283
Type of Work:
Hot Work Electrical/High Voltage
Scope of Work Commisiong machine Confine Space Entry Others (Please specify):
Construction
Work at Height (above 3m)

SECTION 2 : COMPULSORY SHALL BE CHECKED AND FILLED UP BY HOST

Flammable Gas under pressure Reactive

Hazard Identification Chemical Others:
Corrosive Explosive Toxic

High Noise Flying Object Faulty equipment Electrocution Fire Others:

Physical
Trip/Fall Extreme Temperature Oxygen deficiency Exposed to moving machine parts Explosion

Vibration Akward Posture Repititive Motion Heavy Lifting

Ergonomic
High Force Frequent Lifting Standing Work Others:

Ionizing Radiation (X-Ray, UV Ray)

Radiation
Non- Ionizing Radiation (Near UV Radiation, Infrared, Microwave)

Stress Others:
Psychological Workplace Violence

Blood Bacteria/Virus Others:

Biological Insect Bites Fungi/Mold

Hazard Control Backup person/check Signage Fire Extinguisher ELCB/Extension Cord Lockout Tagout (LOTO)
Barricade Step Ladder Scaffolding Scaffolding Welding blanket/sleeve/shield

PPE Safety shoes Safety eyewear Safety gloves Safety mask Breathing Apparatus
Safety helmet Hearing protector Face Shield Safety harness Others :____________________

SECTION 3: PERMIT APPROVAL

REQUESTOR APPROVAL
Requested By, Acknowledged By, Reviewed By, Approved By,

……………… ………………... ……………………. …………………

(Host) (Area Owner) (Facilities/Host Manager) (Health & Safety Personnel)
Name: Mohamad Sufi Name: Haszahar Name: Name:
Date:1323/12/
Nov/21
15/11/21 21 13
23/12/21
Nov 21
Date:15/11/21 Date: Date:
Remark: Remark: Remark: Remark:
SECTION 4: DECLARATION (Contractor to retain and display this work permit during work in progress)
I have understood and will adhere to the precautions to be taken under this permit.

Name: ……WONG TZE SHEONG………………. Signature : ……………..……… 1323

Date: …18 Nov
Dec
Nov 21
2021
2021………………...
(Contractor)
SECTION 5: COMPLETION OF WORK
Scheduled Waste Disposal : Yes / No
I hereby confirm that the above work has been completed in accordance with this
permit. Services have been restored and the work area is ready for re-occupation. NOTES :
(1) All hazardous works carried out by the contractors inside Dyson must use this work permit.
(2) All work must be carried out in 'Buddy System' or with the presence of Project
Checked By, Verified By, Coordinator/Host or Dyson personnel.
(3) No work shall be allowed after 6.00pm unless it is for emergency or urgent works which
must obtain prior approval from the management group or the H&S personnel.
(4) Definition of hazardous work:
Hot Work : Hazardous jobs that involves welding, brazing,cutting and grinding
Confined Space : Jobs carried out in the HIP pit.
High Altitude : Hazardous jobs that involve working in work areas 3m above the floor area.
…………………….…… ………………….……… Electrical Work – Hazardous jobs that involves electrical services or installation in the Electrical
Room and all distribution boards.
(Contractor) (Host) Construction Work – Works that involves the digging of holes, pits or trenches in the ground
Name: Name: and which may place people or properties at risk.
REMINDER : All scheduled waste items (oil, lubricants, chemicals, paints, electrical &
electronic waste, etc) must be properly disposed off in accordance to DOE requirements.
Date: Date : This PTW can be applied for up to 72 hours.

Please return this permit to the Host (Dyson) upon completion of work and inspection. Host to return to Security.

Effective Date : 13/01/2020

Rev:01 Page 1 of 1 Form No:MAM-FR-HS01