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ELECTRICAL WORK PERMIT (For Group Working Oniy) TIL Corpl ESHF/007 HWP Release Date- - -2017 ContractoriPermit Raiser | PTW no. ‘Section 1: To be filled by Cuuster: Location of Work Baan bots Site 1D. Gun | IN-(d48ie ‘Manager Name Contact No. pune kai | Contactors (Company nama, Manager and contact detail) Description of the Work to be undertaken | Tower Erection Work atHeight” Elect tical | Tower Diemanting wootle Cmedee beatistaliivy) Working on Tower ‘Working on Unprotected Roof ‘Working on Parapet Wall ¥ Others metet_KUEH. | | Persons asigned to tack (rs betaine in working at nih). | Name Me aieSls Past Trained Lvés Y Name _Mr. Trained Yes 7 Name Me Trained Yee ¥ Name _l. Name Me. Trained Yes “Name Hr Trained Yes “ Trained Yes ¥ Name Mc Trained Yes ¥ Nome _Mr. Trained Yes ~ C Section 2 : To be filled by Permit issuer Thereby declare that the person Permit Period (Vaid for 1 Day only): | Details of Permit ‘dentiied on this permit is authorized to | Permit is Vaid from ‘Authorizer: | cany out the work at height subjectto | Date 2 | 1! 12Ol% the terms and conditions ofthis permit at ‘Time_10,00 PM TO 6:00PM Contact: | ‘Custer Manager (SigrName) POWER LINES: | 27Area must be clear of power lines or power lines must be de-energized ° Nest, Bee Hive 7 Protected Building Edge/Parapet \WalVExcavation LIFTING & WORKING TOOLS | ZrrpprovediAppropriate Tools JZ“Toots in ‘Good Condition © Lifting Tools inspected by competent person in last six month (attach copy of certificate) PERSONAL PROTECTIVE EQUIPMENT | Te following PPE (tick) shall be wom (must be | checked for wear & tear etc): | Sul Body Hamess 9 Eye protection protection ‘ot protection \27Protective clothing © helmet FC Other (please specty) | FALL PROTECTION ‘Double Lanyard Harness 0 Approved Hames | “Hamess in Dry Condition 9. No part of Hames Missing 2 Hamess & its Parts not damagedidefective 1 Lanyard not damaged Hames inspected by competent Person in last six month ‘Section 3: To be checked by Permit Authorizer | | ‘OF {U Barricedes provided to restrict the movement under tower 10 Caution Tape provided around tower © Caution tape provided around material stocking area EDGE PROTECTION (For RTT & RTP) 1D Barricades provided along building edges to prevent ‘material faling beyond site FITNESS OF PERSONNEL 1D Personnel not suffering from liness including CoughiCold 1 Personnel not under influence of alcohoWHeavy Medication 1 Personnel not on Religious Fast (For Tower Work only) COMPETENCE OF PERSONNEL 13 Personnel are trained and experienced in Height Work TOOL BOX SAFETY TALK © Do's & Don'ts 0 General Safety Guidelines 1.2-PPE's PRECAUTIONS ‘The following precautions have been implemented: 1D Warning notice & Safety Sign provided 10 Emergency Contact Nos.& First Aid box Barricades in position a 2) ») ° )

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