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Permit To Work Format - Ramzan Sugar Mills Limited (RSML)

The permit outlines the format for work permits at Ramzan Sugar Mills Limited. It requires information about the requestor, location, nature of work, workers, type of work permit needed, potential risks and hazards, control measures, required personal protective equipment, other safety controls, sign-offs from supervisors and HSE department. The permit also includes provisions for extensions if needed and closing out the permit once work is complete.

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179 views

Permit To Work Format - Ramzan Sugar Mills Limited (RSML)

The permit outlines the format for work permits at Ramzan Sugar Mills Limited. It requires information about the requestor, location, nature of work, workers, type of work permit needed, potential risks and hazards, control measures, required personal protective equipment, other safety controls, sign-offs from supervisors and HSE department. The permit also includes provisions for extensions if needed and closing out the permit once work is complete.

Uploaded by

cuteboom1122
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Permit To Work Format - Ramzan Sugar Mills Limited (RSML)

Requestor Name: Date: Time:


Location: Machinery / Equipment:
Nature of work:

Workers:
WORK PERMIT TYPE
1. Cold WP 2. Hot WP 3. Confined Space 4. Electrical 5. Work at height
6. Excavation 7. LOTO requirement
HSE RISKS & HAZARDS
1. Chemicals 2. Confined Space 3. Electrical 4. Excavation 5. Ergonomics 6. Explosion
7. Flammeable 8. Fumes/Dust 9. Fall Hazard 10. Fire 11. Heat/Cold stress 12. Height
13. Noise 14. Traffic Movement 15. Any other

CONTROL MEASURES
Isolation Status Hot work controls Status
1. Water/Gas/Chemicals 1. Area clear of combustible material
2. Mechanical/Electrical Drives 2. Fire extinguishers present
3. Hydraulic/Electrical/Gas/Power 3. Fire watch / stand by person
4. LOTO requirement Locks Tags 4. Equipments are fit for purpose:
PPEs Requirement
1. Ear protection 2. Face protection 3. Welding gloves 4. Electrical gloves 5. Safety shoes 6. Safety Helmets
7. Safety Harness 8. Safety Glasses 9. Any other:
OTHER CONTROL MEASURES
1. Machinery/equipment is completely de-energized
2. Sufficient ventilation is present for vessel entry
3. Vessel is completely cooled
4. Work instructions given to workers
5. Barricading / working signs present
6. Electrical power leeds are in good condition
7. Workers are aware of emergency escape routes
8. Nearest fire post identified
9. Any other instructions

AUTHORITIES
Job supervisor Name & Signature:
Area Supervisor Name & Signature:
HSE department:
PERMIT EXTENSION
Work permit extention : Extension granted:
Area Supervisor Name & Signature:
HSE department:
PERMIT CLOSING
1. All equipment removed 2. Housekeeping restored 3. No further activity planned
4. All safe guards have been restored 5. All safeties have been restored
6. Any other comment
Area Supervisor Name & Signature:
HSE department:

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