RISK ASSESSMENT AND ANALYSIS

SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choose the ' Consequence' with the highest rating)
Loss Type Additional "Loss Types" may exist for an
event: Identify & rate accordingly (1) Insignificant (2) Minor (3) Moderate (4) Major (5) Catastrophic
Single Fatality or Loss of Quality of Life / Irreversible impact
(S/H) Harm to People (Safety/Health) First Aid Case/Exposure to Minor Health Risk Medical Treatment Case/Exposure to Major Health Risk Loss Time Injury / Reversible Impact on Health on Health Multiple Fatalities / Impact on health Ultimately Fatal

Material Environment harm (RST) Serious environmental harm

(EI) Environmental Impact Minimal environment harm incident with workplace Material Environment harm (RST) incident (RMT) Major environmental incident (RLT) Major environmental harm – Incident Irreversible

(BI/MD) Business Interruption / Material / Fire No disruption to operation / 1000 SR to Less than 10k SR Brief Disruption to Operation / 10k SR to Less Than 100k SR Partial Shutdown/100k SR to Less than 1M SR Partial Loss of Operation/1M SR to Less than10M SR Substantial or Total Loss of Operation / 10M SR and more
Damage & Other Consequential Losses

LIKELIHOOD Examples (Consider Near-Hits as well as actual events) RISK RATING / PROFILE
The unwanted event has occurred frequently : Occurs in order of (1) or more per year & is likely to
(5) ALMOST CERTAIN reoccur within 1 year 5 (L) 10 (M) 15 (H) 20 (Ex) 25 (Ex)
The unwanted event has occurred infrequently : Occurs in order of less than once per year & is
(4) LIKELY likely to reoccur within 5 yrs. 4 (L) 8 (M) 12 (H) 16 (Ex) 20 (Ex)

(3) POSSIBLE The unwanted event has occurred in the business at some time: or could happen within 10 years. 3 (L) 6 (L) 9 (M) 12 (H) 15 (H)

(2) UNLIKELY The unwanted event has occurred in the business at some time: or could happen within 20 years. 2 (L) 4 (L) 6 (L) 8 (M) 10 (M)
The unwanted event has never known to occur in the business or it is highly unlikely to occur
(1) RARE within 20 years. 1 (L) 2 (L) 3 (L) 4 (L) 5 (L)

Stop operation and review controls - Eliminate, Proactively manage & implement specific Actively manage & monitor – Additional Risk acceptable – Monitor & manage as
Project Name : DD-2021-170 – Bujairi Public Realm Wayfinding (Darriyah Riyadh) GUIDELINES FOR RISK MATRIX avoid risk & implement high priority action plans controls/action plans-Review after 7 days controls is advised & review after 30 days appropriate with frequent review

Contract No. : RISK RATING 16 To 25 12 To 15 8 To 10 1 To 6

RA Number: 01:‫رقم تقييم المخاطر‬ RISK LEVEL (Ex) - Extreme (H) - High (M) - Medium (L) - Low
RA TEAM (NAMES) DESIGNATION SIGNATURES WORKPLACE / TASK / ACTIVITY / PROCESS NAME: DEPARMENT / AREA: Civil

1. R.S.REDDY Safety Engineer DATE:20/12/2023 :

2. Mr. DEBASISH MONDAL Site Manager NEXT REVIEW DATE: 20/12/2024:
EXCAVATION WORK/ Foundation Installation
3. Mr. MANOJ KUMAR MISHRA Operation Manager APPROVED BY MANAGER / SUPERVISOR: MANOJ KUMAR MISHRA
4. SIGNATURE:
RISK
HAZARD IDENTIFICATION CONTROL ASSESSMENT RISK REDUCTION ACTION PLAN

Consequence

Consequence
Risk Issue

Risk Ranking
Likelihood

Likelihood
(Possible Incident) (What can go wrong) (Improve Existing Controls/ Implement Follow up By Whom (Name) & By

Ranking
Workplace/ Activity/ Process/ Hazards Existing Controls Controls
Item

Equipment/ materials (Accident/ Ill health to person, fire or new controls) When (Date) Implemented (Yes
/ No)
property loss)

• Accident resulting serious injury or death to
worker
• Unathorized work to be performed within
a defined location and boundary
• Significant property and appurtenances
damage
• Permit to Work shall be obtained as a pre-
requisite to perform work
• Work shall not be started until duly approved
Permit to Work is available at site and that Safety
Toolbox meeting was conducted
• Work shall not proceed without the presence of
approved Permit to Work with the Permit Receiver
overseeing the activity
● A safe work practice shall be implemented to
reduce the possibilities of accident / incident
●Permit Receiver and Permit Issuer shall visit
together at the site to ensure that workplace
hazards are adequately identified and mitigating
measure shall be established
3 2
3 2
• Permit Receiver shall be trained and
authorized by the Manager to receive a
Permit to Work
●Permit Receiver shall be responsible to
6 oversee for the safety of all workers under 1 2 2 Supervisor/Engineers/Workers YES
his Permit to Work
• All workers attending the toolbox meeting
shall sign on the attendance sheet attached
to the specific Permit to Work
1 2 Supervisor/Engineers/Workers YES

● Permit to Work shall be displayed at the ● All workers shall attend the toolbox
worksite meeting on a daily basis conducted by the
● Permit Receiver shall not leave the area for the Supervising Engineer, Foreman and Permit
• Loss of production whole duration of work
2 2 4 Receiver 0 Supervisor/Engineers/Workers YES
1 Obtain Permit to Work
• Uncontrolled personnel entering a
restricted location
●Permit Receiver shall account all workers under
his Permit to Work before the start of work
• Significant cost due to damages

● Manager, Supervisor, Foreman and all workers ●

shall adhere to all requirements set forth in the ●
Permit to Work, Risk Assessment, Method
• Unidentified hazards with unplanned Statement, Job Safety Procedure and other
• Governmental violation relevant safety practices and standards 0 0
safety mitigating measures

1 of Rev. 2 (08 - April - 2019) Project Business Unit


• Inadequate coordination and area control
• Environmental complaint
protocol
• Lack of safety awareness and knowledge
for the job
• Working without wearing appropriate
Personal Protective Equipment (PPE)
• Improper manual handling
• Failure of equipment may lead to accident or a 3rd party
• Equipment and operator without 3rd party
incident
certificate
• Lack of knowledge in conducting inspection
using checklist
Mobilization / Inspection of heavy
2 equipment (excavator and dump
trucks) at site
• Struck by moving equipment and vehicle
• Incompetent equipment operator or driver
2 of
• Engage in accident resulting injury to
personnel due to lack of safety awareness
• Hand injury
• Arm injury
• Physical injury from slip / trip / fall
• Back injury
• Arm injury
• All operators must be trained and certified by a
third party
• All equipment must be inspected and certified by
• Physical / fatal injury
• Damage of property
• Physical injury from slip, trips and fall
• Vehicular accident
• Accident resulting Injury to personnel
• Property damage of adjacent structure or
appurtenances
• Property damage, fatality or injuries during
the operation of the equipment.
● Site Manager, Supervising Engineer, Foreman
shall designate a Permit Receiver competent
enough to take responsibility in securing the
Permit to Work
• Obtain a valid wok permit
• Ensure that all workers undergo safety induction
that discuss safety policies and standards of
company and Saudi Electricity Company
• Conduct Tool box talk and discuss safe work
procedure, RA, and JSP prior to the start of work. 3
• Ensure that all workers are provided with
required mandatory PPEs such as: Helmet (ANSI
Z89.1, CE EN397), Safety Glass, Safety Shoes, Cover
all, Safety Gloves, Dust Mask
• Use hand gloves for hand protection
• Only up to 20 kg is allowable for each worker to
lift.
• Ensure that access has no obstruction
• If the load is heavier, buddy system is advised
3 2
• Daily equipment inspection must be carried out
by the operator
• All operators must be trained in conducting
inspection of equipment using the checklist
• All equipment must be inspected regularly using 2
checklists by the operator
• The equipment to be used shall be in good
condition
• The equipment must be suitable to perform the
task
• Establish equipment access and shall be free
from any obstruction
• Designate parking area
• Designate location for unloading of materials
• Designate spotter and flagman to guide all
equipment and personnel movement
• All heavy equipment and its driver/operator shall
hold a valid third party certification authorizing
them on the specified equipment to operate
• Select and mobilize only good condition
equipment
• Equipment certification and registration must be
secured and available
• Operator and driver must have certification and
license
Rev. 2 (08 - April - 2019)
●
●
0 0
• Ensure that Tool Box Talk is conducted
daily by the Supervisor and Foreman
• Safety trainings must be conducted
periodically as work requires
2 6 1 2 2 Supervisor/Engineers/Workers YES
• Close supervision is required. Supervisor
and foreman must be present at site.
• Ensure presence of safety personnel
• Conduct trainings for PPE as per activity.
3 2 6 1 2 2 Supervisor/Engineers/Workers YES
• Ensure that all personnel are trained in
proper manual handling
0 0
• Only operators that are certified and
trained can operate the equipment at the
site
• All drivers and operators shall undergo
Defensive Driving Safety Training
• Daily tool box talk must be conducted
6 1 2 2 Supervisor/Engineers/Workers YES
before any work commences
• Equipment Operator shall be oriented on
how to use and fill out the checklist properly
• Equipment inspection checklist shall be
provided and conducted in a daily basis
3 6 1 2 2 Supervisor/Engineers/Workers YES
• Supervising Engineer and Safety Officer
shall ensure that inspection was carried out
thoroughly
0 0
• Site management plan shall be prepared,
approved and implemented to avoid
property damage and personnel accident
0 0
●
●
0 0
• All heavy equipment operator and driver
shall be oriented with the proper use on how
to fill out the daily inspection checklist
• Lease equipment and operator must be
from establish company
• All operator and driver must sign the
drivers’ pledge
2 3 6 1 2 2 Supervisor/Engineers/Workers YES
Project Business Unit

• Dilapidated equipment / Damage or
defective condition of equipment
• Unauthorized entry of the equipment to
the site.
• Damage to underground utlities prior to
Checking and verification of any
3 excavation due to failure to perform pre- • Disruption to production
underground utilities
checks.
• Struck by excavator moving / operating
equipment
• Presence of plant / underground services
3 of
• All heavy equipment shall be inspected by the
authorized operator on a daily basis to ensure that
equipment is in good working condition before
using to the site
• Heavy equipment shall not be used if found any
defects or damage that might affect its safe
• Property damage, fatality or injuries during operation
• Repair of heavy equipment shall not be done on 3
the operation of the equipment.
the site. It must be brought to the designated work
shop and only certified mechanic shall make repair
of the equipment
• Implementation of Log-in and Log-out from the
security post.
• Equipment / vehicle insurance
• Property damage, fatality or injuries during
the operation of the equipment.
• Locate underground services referring to the site
• Damage to property map / drawing.
• Use suitable detectors to check and locate any 3
underground utilities.
• Supervisor and Foreman shall closely monitor to
ensure accurate reading is obtained
• Worker who will perform the verification shall be
knowledgeable and trained in using and
• Accident resulting in injury to worker interpreting the instrument
• Operator must be competent, trained, and
experienced of the task and must be 3rd party
certified holder
• Trained and competent flagman must be
assigned for all heavy equipment operation
• Impact by a sudden operation of equipment • Heavy equipment shall not be allowed at any
may cause serious injuries or property damage time without the presence of dedicated flagman
• Toolbox meeting must discuss the safe use of
equipment to be conducted by Foreman
• Only trained competent operators shall be
assigned to operate any heavy equipment during
mechanical excavation works
• All underground utilities must be identified,
marked with a visible warning or relocated, fixed
and secure
• Area to be excavated must be scanned for
underground services and utilities
• Conduct test pit. Manual excavation is highly
required to prevent any damages to any existing
underground utilities due to machine excavation
• Permit To Excavate must be issued before work
commences
• Spotter must be assigned to guide the heavy
equipment operator specially if underground
utility is found
• Impact and damage to existing plant / • Hand digging only in the vicinity of underground
services
underground facilities
• Properly monitor when hand digging the vicinity
of underground services
• Electrical cables adjacent to excavation shall be
isolated by electrician using permit to isolate
Rev. 2 (08 - April - 2019)
• Pre-selection of equipment and operator
should establish
2 6 1 2 2 Supervisor/Engineers/Workers YES
• Recording and registry for all equipment,
operator and driver shall be made.
0 0
• Report accordingly any noticed
underground utility
2 6 1 2 2 Supervisor/Engineers/Workers YES
●
●
0 0
●
●
0 0
• Flagman training must be conducted
• Acquire as-built drawings of underground
existing facilities prior to any task to be done
• Close supervision is required
• Supervisor and foreman must be present in
the site.
• Conduct safety toolbox meeting and
discuss the work procedures prior to start of
work.
• Supervising Engineer and Safety Officer
4 2 8 shall attend and ensure that toolbox meeting 1 2 2 Supervisor/Engineers/Workers YES
was conducted and discussed according to
the risk assessment of the activity
• At all stages of the excavation, a competent
person must supervise the work and all
workers must be given clear instructions on
working safely in the excavation.
• Ensure proper and adequate supervision by
supervisor/ foreman.
• Site safety officer must ensure that all
excavations are provided with necessary
safety requirements as per SEC safety
standard.
• Close supervision is required
• Supervisor and foreman must be present in
the site
• Training for excavation works must be
3 2 6 conducted 1 2 2 Supervisor/Engineers/Workers YES
• Tool Box Talk shall be provided to the
workers prior to the start of work
Project Business Unit

• Unprotected edges of excavation
• Falling of workers / equipment / tools into
excavation resulting to personnel injury,
fatality, property damage
• All underground utilities must be identified, ● • Ensure proper housekeeping to avoid
marked with a visible warning or relocated, fixed unnecessary materials
and secure ●
• Area to be excavated must be scanned for
underground services and utilities
• Conduct test pit. Manual excavation is highly
required to prevent any damages to any existing
underground utilities due to machine excavation
• Permit To Excavate must be issued before work
commences
• Spotter must be assigned to guide the heavy
equipment operator specially if underground
utility is found
• Hand digging only in the vicinity of underground
services
• Properly monitor when hand digging the vicinity
of underground services
• Electrical cables adjacent to excavation shall be
isolated by electrician using permit to isolate 3 2 6 1 2 2 Supervisor/Engineers/Workers YES
• Fall prevention barriers (barricades) with signs
shall be erected around excavation at least 1
meter away
• Concrete Jersey barrier installed at a safe
distance from excavation, preventing vehicles from
falling into the excavation. Standard barricading
for UG shall be complied accordingly.
• Wear appropriate PPE – hard hats, safety glasses,
safety mask, safety gloves and safety shoes

• Check the condition of excavation at all times for
possibility of collapse or cave in
• Excavation walls that are deeper than 1.5 meter
must be sloped / benched or shored depending on
Perform excavation using heavy the type of materials being excavated
4 equipment such as skid loader, • Erosion control measures must be considered
backhoe, Excavator when using dewatering operations
• Provide temporary sum pit and sub pump to
remove water inside excavation
• Unstable soil condition (due to type, • If equipment is being used above the trench,
• Cave-in (sudden collapse of soil)
vibration, and water) then no operatives should be in the trench when
the machine is in use • Stability of
soil must be ensured
• Report any signs of cave-in to supervisor.
• Excavation training must be conducted
prior to start of activity
• Hazard awareness and best practices
relevant to excavation must be conducted.
• Provide hole watcher to monitor the entry
& exit of entrant
• Practice good housekeeping while working
in and around excavations and trenches
0 0

• Buildup of harmful gases in the excavation • Health hazards (asphyxiation / collapse due
for 1.2 meters confined space
• All excavated materials must be a minimum of 1
meter away from the edges of excavation or
totally removed from the site.
• Excavation must be properly barricaded
physically, and DANGER DEEP EXCAVATION signs
must be provided
• Heavy equipment parking must be a minimum of
3 meters away from the edges of excavation
• Excavations > 4 ft. deep (1.20 m) that may
to inhalation of hazardous gases)
develop hazardous atmospheres shall be
considered a confined space
• Provide Gas Test equipment and conduct
gas test by competent persons if suspected
to have a buildup of unknown gas
• Contact the site area
in advance and agree that access to the
specific area is acceptable
• Follow safe work practices
• Conduct confined space training for the
3 2 6 involved personnel 1 2 2 Supervisor/Engineers/Workers YES

4 of Rev. 2 (08 - April - 2019) Project Business Unit


• Poor access and egress
• Working under direct sunlight
• Exposure to dust
• Struck by moving equipment (such as
dump truck, etc.)
• Falling of heavy equipment into the
excavation
Loading of excavated soils to a
5 • Soil cave in and collapse
dump truck
5 of
• Use safe access while entering and exiting
excavations and trenches
• Each excavation must be provided with proper
access and egress
• Ladders must be secured when workers are
required to work inside the excavation for manual
excavation
• Avoid taking short cuts or jumping in and out of
excavation
• Aisles, stairs, and passageways shall be kept clear
• Materials must not be carried in a manner that
will provide obstruction in the way ahead
• Materials shall be stored in designated areas
• Materials and tools shall be stored away from
exposed edges
• Ensure proper access and egress in the
• Personal injury due to slip and trip hazards excavation
from the obstruction of materials on access / • Provide proper illumination or blinker lights
egress along the excavation in order to be identified
during night time.
• No tools and equipment shall be stored close to
the edge of excavation.
• Modify work schedules and arrange frequent
rest periods with water breaks in shaded area
• Provide adequate cool water to workers close to
the work area.
• Heat exhaustion/ stress
• Use an approved dusk mask (such as 3M, etc.)
• Dust control must be thoroughly done around
the excavation area
• Respiratory illness
• Provide trained flagman equipped with green
and red flags to control the moving equipment
• Serious accident and even death to personnel • There shall be no working personnel inside the
excavation while excavation and loading of soils is
ongoing
• Conduct tool box talk prior start to work.
• Establish safe distance from equipment to the
edge of excavation
• Concrete Jersey barrier shall be maintained and
installed at a safe distance from excavation,
• Significant property damage preventing vehicles from falling into the excavation 3
• Provide adequate shoring with approve shoring
materials on an excavated area
• Physical injury / property damage • Provide complete physical barricades with
flagman standing outside the barricades
Rev. 2 (08 - April - 2019)
• Hoses / cables shall be positioned in such a
way that it will not create obstruction on the
access and work areas
• Warning signs and safety barricades shall
be used whenever a slip, trip or fall hazard
has been identified but cannot be corrected
or removed immediately
3 2 6 1 2 2 Supervisor/Engineers/Workers YES
• Establish a complete heat illness
prevention program
• Provide heat stress training, and its
prevention
• Ensure workers drink at least a pint of
water every hour
• Workers must be advised to drink plenty of
fluids
• Workers must be advised to drink water
more often and even before they feel thirsty
3 2 6 • Workers must avoid beverages that contain 1 2 2 Supervisor/Engineers/Workers YES
alcohol or caffeine.
• Workers must wear light-weight, light-
colored, and loose-fitting clothes
• Water sprinkling shall be carried out to
avoid dust emissions, where necessary
• Supervisor and foreman must ensure
0 adequate monitoring of activities 0
• All heavy equipment operator including
rentals shall attend Defensive Driving
Training for the driver
2 3 6 1 2 2 Supervisor/Engineers/Workers YES
• Equipment must have back-up alarms
2 6 1 2 2 Supervisor/Engineers/Workers YES
• Supervisor and foreman must ensure
adequate monitoring of activities
2 3 6 1 2 2 Supervisor/Engineers/Workers YES
Project Business Unit

• Incompetent driver
• Exposure to dust
• Struck by moving equipment (such as
dump truck, etc)
• Exposure to Dust
Shifting and offloading of excavated • Reckless driving
6 • Significant damage to property
soils into the designated area
• Busy traversed road
• Populated area
• Unwanted materials laid inside and outside
the excavation area
• Ladder and hand tools that block in the
walkway
• Manual handling
Housekeeping, Clearing the area
with all used materials, tools and
7 equipment and brought to the
designated storage and disposal
area
• Materials lying on the ground
• Protruding object / materials at the site
• Uncollected / scattered rubbish
6 of
• Disruption to activity and productivity
• Respiratory illness
• Vehicular accident resulting to injury or ill
health to worker or bystander
• Ill health to worker due to inhalation of dust
• Vehicular accident resulting to injury or ill
health to worker or bystander
• Ill health to worker due to inhalation of dust
• Physical injuries from slip, trips and fall
• Physical injuries from slip, trips and fall
• Manual handling can lead to musculoskeletal • Facilitate training for manual handling.
disorder • Observe proper posture during manual lifting,
pushing, pulling, etc.
• Property damage
• Accident resulting injury to worker
• Fire
• All drivers must be trained and have a driving • Proper training must be provided to the
license operator / driver
• Filled dump trucks shall be covered with screen
or equivalent materials to prevent spoils from
spilling on the road while transporting to dump
site 2 3 6 1 2 2 Supervisor/Engineers/Workers YES
• Foreman shall ensure that cover is installed
properly
• Use an approved dusk mask (such as 3M, etc.) • Water sprinkling shall be carried out to
• Dust control must be thoroughly done around avoid dust emissions, where necessary
the excavation area
0 0
• Provide trained flagman equipped with green
and red flags to control the movement of
equipment.
• Suitable traffic management plan shall be
established such as segregation of pedestrian lanes 2 3 6 0 Supervisor/Engineers/Workers YES
from vehicle access ways.
• Slowly dump the soil to minimize the airborne of • Check surrounding for any equipment or
dust materials that might be covered during
3 2 6 dumping of excavated soil 1 2 2 Supervisor/Engineers/Workers YES
• Driver shall follow instruction from the foreman • Driver shall be trained and follow defensive
driving technique
0 0
• Filled dump trucks shall be covered with screen • Driver shall follow designated route going
or equivalent materials to prevent spoils from to the dumping area
spilling on the road while transporting to dump
site
• Foreman shall ensure that cover is installed
2 3 6 1 2 2 Supervisor/Engineers/Workers YES
properly.
• Designated offloading (dump site) shall be • Designated dumping area shall be away
established with suitable demarcation and signs from residential area
posted.
2 3 6 1 2 2 Supervisor/Engineers/Workers YES
• Conduct and maintain daily housekeeping ●
• Foreman must designate 1 or 2 persons to ●
maintain good housekeeping.
2 0 0
• Maintain daily proper housekeeping ●
• Additional person for housekeeping must be ●
provided if necessary.
• Provide designated trash disposal area so
0 0
anybody can perform housekeeping
2 3 6 0 Supervisor/Engineers/Workers YES
• Provide storage box for cables • • Daily inventory of the equipment •
Labeling of storage box (good items, scrap / Training / awareness regarding the
3 2 6 1 2 2 Supervisor/Engineers/Workers YES
damage items, by capacity, etc.) segregation of waste
• Immediate disposal or sending the damage one
•toRemove
the storeallkeeper
unwanted / protruding materials / • Good housekeeping at the site
object at the site • Daily toolbox meeting
0 0
• Provision of standby fire extinguisher • Records and registry for fire extinguisher
• Periodical inspection and / or color coding for • Records /
fire extinguisher registry for the quantity of waste disposed
• Provision of waste skip in the strategic location
at the site with marking 2 3 6 1 2 2 Supervisor/Engineers/Workers YES
• Provision of color coded waste bins at the site
Rev. 2 (08 - April - 2019) Project Business Unit

• Unsecured electrical equipment, energized
equipment
• Undisposed waste materials
• Unaccounted workers
8 Closing of Permit to Work
• Inadequate communication
• Poor storage of chemical, flammable and
combustible materials and etc.
• Unattended unsafe condition
7 of
• Permit Receiver shall ensure that housekeeping
• Significant property and appurtenances in done before, during and after the work
damage • Electrical equipment shall be properly secured,
distribution board closed and padlocked
2 2 4 0 Supervisor/Engineers/Workers YES
• All waste materials generated from the work • Supervising Engineer and Foreman shall
shall be disposed properly and shall not be left adhere to the proper housekeeping and
• Governmental violation unattended at the worksite 2 3 6 storage of materials at the designated 1 2 2 Supervisor/Engineers/Workers YES
location
• Permit Receiver shall account all worker under ●
his Permit to Work and ensure all have signed out ●
• Accident resulting serious injury or death to on the attendance sheet and clear of the area
2 3 6 0 Supervisor/Engineers/Workers YES
worker
• Site Manager shall be responsible on the ●
effective implementation of the Permit to Work ●
• Loss of production 2 2 4 0 Supervisor/Engineers/Workers YES
• All materials used at the site such as chemicals, ●
flammable and combustible materials shall be ●
stored at the designated storage at the end of
• Environmental complaint 0 0
each day
• Permit Issuer shall visit the work location to • Mobile equipment shall properly parked on
verify good housekeeping was conducted before a designated equipment laydown
• Significant cost due to damages closing the Permit to Work 2 2 4 1 2 2 Supervisor/Engineers/Workers YES
● 0 ● 0
●
● ●
●
0 0
●
● ●
●
0 0
● ●
Rev. 2 (08 - April - 2019) Project Business Unit
RA Prepared by : RA Accepted by : RA Approved by SEC / Safety Rep: RA Aprroved by SEC-HV&EHVPD:
Name & Sign Name & Sign Name & Sign Name & Sign
Desgination Desgination Desgination Desgination
Date Date Date Date