Permit number : P210-00-6694941

State : Live (16 Mar 08:14 - 16 Mar 12:30)

Lifetime expires on 18-03-2024

Working at Height - High

Title Painting of Kettle B1 & Structure

Description of work: 1.Mobilization of material at working area

2.Erection of scaffolding
3.Manual Cleaning of Kettle & Structure
4.Painting of Kettle & Structure
5.Dismantling of scaffolding
6. Area House Keeping

Emergency Information
Muster point CFP gate

Communication Verbal/Phone call

Other Emergency Information Moin sab 033220294451

Abdul Hadi 03268040480

Sign-off in the field

This permit is only considered Live when both Permit Holder and Permit Issuer have provided their signatures below.

Permit Issuer Signature Permit Holder Signature

Name:............................................................................ Name:............................................................................

Signature:....................................................................... Signature:.......................................................................

Date:............................................................................... Date:...............................................................................

Details

Planned Start Date: 08 Mar 2024

Planned End Date: 16 Mar 2024

Site: DS GC LSC Keamari

Area Authorization DS GC LSC Keamari

Work locations: P210 - Blending & Main Warehouse

Affected locations P210 - Main Tank Farm

Equipment description: B-1 Kettle

Hazardous Substance and Hazardous Area Slip, Trip ,Fall - Paint

classification
Work order number: Nil

Work Performer: NTS

Vehicles, Equipment and Tools to be used 1. Hand Tools

2. Hand Trolley
3. Folding Pipes
4. Wheel Cart
5. Paint Roller
6. Paint Brush
7. Sand paper, Scraper
8. Paint Remover
Expected Number of People 10
P210-00-6694941 03/16/2024 08:27 Page 1 of 4
ICC Requirement None

Is Start Work Check required? No

Lead Discipline: Operations

Initial Gas test by Authorised Person: Yes

Continuous gas monitoring required? No

Influence of nearby activities:

Hazardous Area Classification Hazard Free - No flammable material in area

Expected Re-issue Date:

General comments

Any information entered should not affect the * Ensure All PPE's.
assigned risk level, identified hazard/controls * Follow Life Saving Rules.
or permit type: * House keeping on daily base.
* Follow all Working at Height Protocols

Initial signatures
Type Name: Date: Dep./Company:

Authorise by Permit Authoriser Muhammad Moin Siddiqui 11 Mar 2024 09:36 Shell DS GC LSC
High Risk
Verify by Permit Verifier Mohammad Waseem 08 Mar 2024 14:51 ASIL

Request by Permit Requester Faizullah 08 Mar 2024 14:36 NTS

Signature History
Type Name: Date: Dep./Company: Remarks:

Accept re-issue by Permit Faizullah 16 Mar 2024 08:25 NTS

Holder
Re-issue permit by Permit Muhammad Moin 16 Mar 2024 08:14 Shell DS GC LSC
Issuer Siddiqui
Suspend by Issuer Mohammad Waseem 15 Mar 2024 11:48 ASIL

Suspend by Permit Holder Faizullah 15 Mar 2024 10:46 NTS

Accept re-issue by Permit Faizullah 15 Mar 2024 08:06 NTS

Holder

P210-00-6694941 03/16/2024 08:27 Page 2 of 4

 Working at Height Workpermit
P210-00-6694941

Substances to be measured Carbon Monoxide [CO <35 ppm]

Hydrocarbon [LFL <1 perc]

Hydrogen Sulphide [H2S <10ppm]

Oxygen [O2 20perc - 21.5 perc]

Note - The printed measurement are the last measurement for each substance, entered into Permit Vision

Date Time Substance Value Signer Remarks

16 Mar 2024 08:24 Carbon Monoxide [CO 0.00 Mohammad Waseem
<35 ppm]
16 Mar 2024 08:24 Hydrocarbon [LFL <1 0.00 Mohammad Waseem
perc]
16 Mar 2024 08:24 Hydrogen Sulphide 0.00 Mohammad Waseem
[H2S <10ppm]
16 Mar 2024 08:24 Oxygen [O2 20perc - 20.90 Mohammad Waseem
21.5 perc]

P210-00-6694941 03/16/2024 08:27 Page 3 of 4

 Keep this record with the PTW paper copy, & display these at the worksite

All members of the work party have participated in the LMRA and are Name of holder Faizullah
familiar with the Jobscope and Hazard&Controls.
Company NTS
Name Initials Name Initials
Permit number P210-00-6694941
......................... ......................... ......................... .........................
Date 16 Mar 2024
......................... ......................... ......................... .........................

......................... ......................... ......................... ......................... What kind of work are you going to do?

......................... ......................... ......................... ......................... Painting of Kettle B1 & Structure

......................... ......................... ......................... .........................

Has the Permit Issuer discussed the hazards & Does the work party know the emergency alarm
controls with the Permit Holder? Yes n/a and action required in event of an alarm or Yes n/a
accident?
Has the Permit Holder warned others that may be
affected by your work? Yes n/a Does the work party know the most effective Yes n/a
escape route and the location of the nearest
muster point?
Is there conflicting work that may affect you? Yes n/a Yes n/a
Does the work party know the location of the
If yes describe hazards and controls below.
nearest eyewash station, emergency shower, first
aid kit and AED device?

Are there additional hazards that need to be controlled? If newly identified hazards are material changes to the permit, contact Permit Issuer!

Hazards Controls / Recovery Measures

.............................................................................................................. ..............................................................................................................

.............................................................................................................. ..............................................................................................................

.............................................................................................................. ..............................................................................................................

Pictograms for key hazards Indicate which Life Saving Rules are applicable.

Bypassing Safety Confined Space Driving

Controls

Obtain authorization Obtain authorization before Follow safe driving rules

FIRE AND HEIGHT MOTION
before overriding or entering a confined space
EXPLOSION
disabling safety controls
Energy Isolation Hot Work Line of Fire

Verify isolation and zero Control flammables and Keep yourself and others out
PEOPLE TOXICS energy before work ignition sources of the line of fire
begins
Safe Mechanical Work Authorisation Working At Height
Lifting

Plan lifting operations and Work with a valid permit Protect yourself against a fall
control the area when required when working at height

P210-00-6694941 03/16/2024 08:27 Page 4 of 4