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    PTW No.: - : Excavation Permit

    Uploaded by

    bhaskar
    This excavation permit document outlines a 4-stage approval process for excavation works. Stage 1 requires the requester to check that various safety requirements are met, such as electrical isolation, barriers, lighting, and toxic/explosive checks. Stage 2 requires endorsement from environmental health and safety personnel after inspecting the location. Stage 3 requires the site manager's approval after a thorough inspection. Stage 4 requires acknowledgment from the job supervisor that they understand the nature and safety of the work.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PTW No.: - : Excavation Permit

    Uploaded by

    bhaskar
    717 views1 page
    This excavation permit document outlines a 4-stage approval process for excavation works. Stage 1 requires the requester to check that various safety requirements are met, such as electrical isolation, barriers, lighting, and toxic/explosive checks. Stage 2 requires endorsement from environmental health and safety personnel after inspecting the location. Stage 3 requires the site manager's approval after a thorough inspection. Stage 4 requires acknowledgment from the job supervisor that they understand the nature and safety of the work.

    Original Description:

    SQG

    Original Title

    2c Ptw Excavation

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    This excavation permit document outlines a 4-stage approval process for excavation works. Stage 1 requires the requester to check that various safety requirements are met, such as electrical isolation, barriers, lighting, and toxic/explosive checks. Stage 2 requires endorsement from environmental health and safety personnel after inspecting the location. Stage 3 requires the site manager's approval after a thorough inspection. Stage 4 requires acknowledgment from the job supervisor that they understand the nature and safety of the work.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    717 views1 page

    PTW No.: - : Excavation Permit

    Uploaded by

    bhaskar
    This excavation permit document outlines a 4-stage approval process for excavation works. Stage 1 requires the requester to check that various safety requirements are met, such as electrical isolation, barriers, lighting, and toxic/explosive checks. Stage 2 requires endorsement from environmental health and safety personnel after inspecting the location. Stage 3 requires the site manager's approval after a thorough inspection. Stage 4 requires acknowledgment from the job supervisor that they understand the nature and safety of the work.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    EXCAVATION PERMIT

    TPL UI / EHS / 2C Rev:0

    Date: 01-Oct-15

    PTW No.:__________________
    Contractor / Dept
    Location of Work
    Description of
    works
    Permit validity
    Date / Time:
    period
    This permit is valid only for the day, time and period stated above. The conditions of issue must be
    complied with throughout the duration of the work. This permit may be withdrawn at any time. You are
    responsible for the copy of this permit and must produce it on request.
    STAGE 1 PERMIT REQUESTER (Only TPL UI Engineer / Supervisor)
    I have checked and confirmed that the following safety requirements have been complied with:
    ELECTRICAL ISOLATION REQUIRED

    BARRIER AND WARNING SIGN BOARDS REQUIRED

    EQUIPMENT ISOLATED

    ADEQUATE LIGHTING

    TRACK ISOLATED

    NO SMOKING OR NAKED FLAME

    WARNING SIGNALS POSITIONED

    SCAFFOLD REQUIRED

    LOOKOUT MAN

    FIRST AID KIT

    EXPLOSIVITY CHECK

    FIRE EXTINGUISHER

    TOXICITY CHECK

    LIFE LINE REQUIRED WITH HANDLER

    OXYGEN GREATER THAN 18%

    SAFE ACCESS TO AND EGRESS FROM EXCAVATION

    SELF CONTAINED BREATHING APPRATUS


    REQUIRED

    CONFIRMED NO UNDERGROUND SERVICES SUCH AS


    GAS, WATER PIPES, POWER GRID/TELECOM CABLES

    REGISTERED OPERATOR AND DAILY M/C


    INSPECTION RECORDS REQUIRED

    SHORING REQUIRED (MORE THAN 1.5 M) (PE DESIGN


    IF MORE THAN 4M DEPTH)

    TOOLBOX MEETING & RECORD

    BARRICADES / TOEBOARDS AROUND PIT

    Name:

    Designation

    Date / Time :

    Signature :

    STAGE 2 - ENDORSEMENT BY TPL UI EHS PERSONNEL


    I have inspected the above-stated location and confirmed that the recommended safety measures are in place and the said location
    is safe for work.
    Name:

    _________________

    Designation:

    __________________

    Date / Time:

    _________________

    Signature:

    __________________

    STAGE 3 - APPROVAL BY SITE MANAGER / ENGINEER


    I am fully satisfied that a thorough inspection and proper assessment of the work area and its surrounding have been made so that
    the excavation works can be carried out safely.
    Name:

    _________________

    Designation:

    __________________

    Date /Time:

    _________________

    Signature:

    __________________

    STAGE 4 - JOB SUPERVISOR / FOREMAN

    ACKNOWLEDGED BY

    I have read the conditions relating to the work to be performed.


    I fully understand the nature of work and the safety compliances.

    Name:

    ______________________

    Name / Designation:___________________________________

    Position:

    ______________________

    Sign / Date: _________________________________________

    Sign/Date: ______________________

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