Elevated WP
-
Upload
jamilhse7759 -
Category
Documents
-
view
3 -
download
2
Transcript of Elevated WP
JABAL OMAR DEVELOPMENT PROJECT-MAKKAH
ELEVATED WORK PERMIT
PERMIT NO.COMPANY:MANPOWER:
START DATE:TIME:DATE EXPIRES:TIME EXPIRES:
LOCATION:AREA:
Section A: SAFE WORK PLAN
RESPONSIBLE SUPERVISION (Please Print Name)
PROJECT ENGINEER:SUPERVISOR:FOREMAN:
Description of the work:
S/NHAZARDSPRECAUTIONS
Section B: PRIOR TO START OF ELEVATED WORK
ENSURE THAT THE FOLLOWING CRITERIA ARE MET
YNN/A100% Fall Protection complied.YNN/ACables/cords are raised 6ft. above surface and safety flags are provided.
YNN/AScaffolds are complete and tagged safe for use.YNN/AWalkway is clear of scattered debris, tools and materials.
YNN/AAccess is clear and free of obstruction. Access ladder is secured and free of defects.YNN/AGas cylinders secured or mounted on a trolley or rack.
YNN/AFull body harness with 2 lanyards and shock absorber worn where required. 100% PPE compliance.YNN/AOpen areas are adequately covered and protected. Warning signs are conspicuously posted
YNN/AHot Work/Cold Work permit completed where required.YNN/AVertical ladder is not allowed. For elevation higher than 12ft. side step scaffold is required.
YNN/ASafety Officer designated to the area.YNN/AFire blanket/welding screen for welding, cutting/grinding works provided.
YNN/ASafe Work Plan submitted alongside with elevated work permit.YNN/AElevated work will not be performed above fuel driven equipment.
YNN/AProper and adequate housekeeping is maintained.YNN/AElevation Work has safe access and egress and secures anchor points.
Section C: AUTHORIZATION TO PROCEED WITH ELEVATED WORK
This is to certify that the above criteria are satisfactorily met and related work permits and safe work plans are completed.
TASK SUPERVISOR/G.FOREMAN/FOREMANNAME (Please Print):
SIGNATURE: DATE:
SITE ENGINEERNAME (Please Print):
SIGNATURE: DATE:
APPROVED BY:
AREA SAFETY SUPERVISOR/SITE SAFETY SUPERVISORNAME (Please Print):
SIGNATURE: DATE:ZONE MANAGER/PROJECT ENGINEER/LEAD ENGINEERNAME (Please Print):
SIGNATURE: DATE:
Section D: EXTENSION OF WORK PERMIT
REQUEST BY:TASK SUPERVISORNAME:
SIGNATURE:SITE ENGINEERNAME:
SIGNATURE:DATE/TIME EXPIRES:MANPOWER
APPROVED BY:AREA SAFETY SUPERVISOR:NAME:
SIGNATURE:SAFETY SUPERVISOR:NAME:
SIGNATURE:ZONE MANAGER/PROJECT ENGG/LEAD ENGGNAME:
SIGNATURE: