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    Cold Work Permit

    Uploaded by

    samar

    Copyright:

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

    Cold Work Permit

    Uploaded by

    samar
    6 views1 page

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Copyright:

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

    Cold Work Permit

    Uploaded by

    samar

    Copyright:

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

    PERMIT-TO-WORK

    COLD WORK PERMIT

    Project Name Project No. Permit No.

    1. Name of Contractor:
    2. Location of work:
    3. Details of work to be carried out:
    4. Plant/Equipment to be used:
    5. Activities to be conducted on-site Ye Precautions/Safeguards/Controls
    s

    Additional Protective Clothing/Equipment Required:

    Other Necessary Precautions:


    Gas Tests Required Yes No Results

    6. Permit Validity

    From: Date: / / Time: ____________ Until: Date: / / Time: ____________

    7. Authorisation Issuing Authority:


    Subject to all the Precautions listed in Section 5 (above) being taken, I consider it safe to carry out the work
    stated in Section 3 (above)
    Issuing Authority (Print Name) : Signature:
    Title : Date/Time :

    8. Acknowledgement Performing Authority:


    I have read and fully understood the conditions of this Permit. These have also been fully explained to the
    persons who will carry out the work.
    Recipient Name: Signature:
    Title : Date/Time :

    9. Cancellation :
    I have completed the work stated in Section 3 (above) and have restored the work location to a safe and
    orderly condition. I have returned this Permit to the issuing Authority.
    Recipient Name: Signature:
    Title : Date/Time :

    I have accepted that the work has been safely completed.

    Issuing Authority: Signature:


    Title : Date/Time :

    THIS PERMIT IS AUTOMATICALLY SUSPENDED UPON EMERGENCY ALARMS SOUNDING


    CHECK WITH THE ISSUING AUTHORITY BEFORE RECOMMENCING WORK
    Dist.: Issuing Authority (PTWC), Performing Authority (Site), Subcontractor.

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