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    Draft PTW

    Uploaded by

    mohamad nur saufi
    This permit outlines the requirements and authorization for work. It requires details of the work including location, hazards, protective equipment, and additional documents. The permit is valid for 12 or 24 hours and work must stop if alarms are activated, requiring reauthorization. Sign off is needed from the applicant, supervisor, and approving authority before, during, and after work.

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

    Draft PTW

    Uploaded by

    mohamad nur saufi
    146 views1 page
    This permit outlines the requirements and authorization for work. It requires details of the work including location, hazards, protective equipment, and additional documents. The permit is valid for 12 or 24 hours and work must stop if alarms are activated, requiring reauthorization. Sign off is needed from the applicant, supervisor, and approving authority before, during, and after work.

    Original Description:

    THIS IS A DRAFT FOR OFFSHORE VESSEL PERMIT TO WORK(PTW)

    Original Title

    DRAFT PTW

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    © © All Rights Reserved

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    This permit outlines the requirements and authorization for work. It requires details of the work including location, hazards, protective equipment, and additional documents. The permit is valid for 12 or 24 hours and work must stop if alarms are activated, requiring reauthorization. Sign off is needed from the applicant, supervisor, and approving authority before, during, and after work.

    Copyright:

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

    Draft PTW

    Uploaded by

    mohamad nur saufi
    This permit outlines the requirements and authorization for work. It requires details of the work including location, hazards, protective equipment, and additional documents. The permit is valid for 12 or 24 hours and work must stop if alarms are activated, requiring reauthorization. Sign off is needed from the applicant, supervisor, and approving authority before, during, and after work.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    You are on page 1of 1

    PERMIT TO WORK PTW NO :

    1) DETAILS (Tick Applicable Boxes)

    A. COMPANY

    PESG CONTRACTOR :

    B. TYPES OF WORK

    HOT WORK ENERGY ISOLATION WORKING AT HEIGHT

    C. DETAILS OF WORK

    Description :

    Location :

    No of Pax :

    D. WORK HAZARDS

    Line of fire Pinch points High Noise Geohazard


    High Pressure Chemical Exposure Sharp objects Drilling hazard
    Severe Weather Heavy lifting Repetitive Motion Electrocution
    Gas release Falling Objects Sources of Ignition
    Limited access/egress Slippery surface Mechanical lifting

    Others :

    E. PERSONNEL PROTECTIVE EQUIPMENT (PPE)

    Safety Helmets Suitable Gloves REQUIREMENTS: Coverall, Safety Helmets, Safety Shoes and Safety Glass
    Coverall Life Jacket/Work vest are MANDATORY in PPE Zone.
    Ear Muffs / Ear Plugs Body Harness and Lanyards
    Safety shoes Dust Mask / Respirator
    Goggles / Face Shield / Chemical Suit
    Welding Shield

    Other:

    F. ADDITIONAL DOCUMENTS REQUIRED TO ACCOMPANY PERMIT TO WORK FORM

    Job Hazard Analysis (JHA) Safety System Isolation / Lock Out - Tag Out
    Radiation Certificate Electrical Permit To Work
    Excavation Certificate Electrical Isolation Certificate
    Lifting Certificate Safety Checklist
    Gas Test Certificate Scaffolding Certificate
    Method Statement (Scope of Work) Confined Space Entry Certificate

    Other:

    G. WORK PERMIT SPECIAL PRECAUTIONS

    Standby man / fire watcher must be in attendance at all times Others:


    Safety system / alarm to be tagged and overide
    Hazardous Drains or Vents in vicinty to be isolated
    Gas, Flame and Smoke Detections to be marked or isolated
    Combustible Materials removed or protected

    2) VALIDITY

    1 This permit is only valid for specific time frame ( refer below time figures ).
    2 Regular check for the safe operation to be done hourly or when required by Supervisor.
    3 For Hot Work, Entry Into Confined Space, and Working at Height required company authorisation approval.

    12 hours(1 SHIFT) 24 hours(1 DAY) Remarks:

    IMPORTANT NOTE:
    THIS PERMIT IS AUTOMATICALLY SUSPENDED WHEN THE "EMERGENCY ALARM" IS ACTIVATED. WORK MUST BE STOPPED, WORK AREA MUST BE MADE SAFE AND THE PERMIT
    RETURNED TO AUTHORITY. THIS PERMIT MUST BE RE-VALIDATED BY APPROVING AUTHORITY BEFORE RECOMMENCE THE JOB.

    3) AUTHORIZATION

    A. PERMIT APPLICANT B. AUTHORISED SUPERVISOR C. APPROVING AUTHORITY

    Sign: Date: Sign: Date: Sign: Date:

    Name: Time: Name: Time: Name: Time:

    4) COMPLETION

    A. PERMIT APPLICANT B. AUTHORISED SUPERVISOR C. APPROVING AUTHORITY

    Sign: Date: Sign: Date: Sign: Date:

    Name: Time: Name: Time: Name: Time:

    Original : Control Room / Bridge Work location Permit Applicant

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