PTW – lifting permit
Magicsoft Asia night
PROJECT :
PTW – lifting permit
Part 1: Application
Validity Period (Date & Time of work) :
From: 09/08/2018 (Date) 19:00 (Time)
To: 10/08/2018 (Date) 07:00 (Time)
Contractor :
Magicsoft Asia
No. of Supervisors : test
Description of work : test
No. of Workers : 10
Daily Check By Work Supervisor-In-Charge and/or Safety Assessor (Yes, No, “NA“ for Not Applicable)
Minimum Safety Requirements
Approved Risk Assessments available Yes
Safe Work Procedures available Yes
Lifting Plan available Yes PTW/ Location Plan displayed at place of work Yes
Workers are briefed on the hazards & corresponding control measures Yes
Workers are medically fit to work/ not feeling unwell/ not overworked Yes
Workers are reminded to do Last Minute Risk Assessment (LMRA) before start work Yes
Safety barricade & warning signs erected to prevent unauthorized entry Yes
Adequate lighting provided to ensure visibility while lifting Yes
Lifting Team Organisation Chart Yes
Competent Lifting Supervisor appointed & present during lifting operation Yes
Competent Riggers & Signallers appointed & present during lifting operation Yes
Competent Crane Operator appointed & operating crane Yes
Proper identification of lifting team members on site – colour helmet & vest Yes
Lifting crew equipped with whistle & walkie talkie Yes
LM/ LG/ LA certificate valid & available Yes
Lifting gears & appliances inspected & color coded before use Yes
Proper storage of lifting gears e.g. proper racks or stands Yes
Sufficient taglines provided & used during lifting operation Yes
Competent Mechanic appointed Yes
Monthly maintenance checks conducted & documented Yes
MOM Approved Crane Contractor & Erectors appointed & present during erection/ dismantling Yes
Safe access for mobile crane provided e.g. steel plate access/ PE Design Yes
Mobile crane/ lorry crane outriggers fully extended and resting on steel plates Yes
Inspection of work area after inclement weather – safe to work after inclement weather Yes
Others :
Part 2: Check & Endorsement
a) I have read & understood this permit & agree to work in accordance with the provisions of the RA/ SWP/ Method Statement & the safety requirements stated in this permit.
b) I have checked and satisfied that the confined space is safe & healthy for persons to enter and work in
a. Applicant / Work Supervisor (Manhole/ Confined Space/ Tunnel Supervisor)
Name Keke –
Signature
Time 16:56
b. Safety Assessor (Shimizu) (Confined Space Safety Assessor)
Name
Safety Assessor
Signature
Time 11:06
c. Shimizu Engineer/ Supervisor In-Charge (Manhole/ Confined Space/ Tunnel Supervisor)
Name Engineer
Signature
Time 11:07
Part 3: Issued By
a) I am satisfied that proper evaluation of risk & hazards involved based on available information
b) I am satisfied that the confined space is safe & healthy for person to enter and work in
c) I am satisfied that effective steps have been taken to prevent any ingress of toxic/flammable subst/gas/vapor
d) The working personnel are informed of the hazards & protection counter measures to be taken
Site Overall In-Charge (SC PM / Appointed Duty Personnel)
Name PM
Signature
Time 11:07
Part 4: Notice of Revocation or Closure
a) Work has been terminated/ completed
b) Housekeeping has been carried out
c) Work area is safe for other personnel
Applicant/ Work Supervisor (Manhole/ Confined Space/ Tunnel Supervisor)
Name Applicant
Signature
Time 11:08
Part 5: Confirmation of Revocation or Closure
a) Work has been terminated/ completed
b) Housekeeping has been carried out
c) Work area is safe for other personnel Site Overall In-Charge (SC PM / Appointed Duty Personnel)
Name PM
Signature
Time 11:08
Photo Attachment
Safety barriers & warning signs erected to prevent unauthorised entry | Confined Space Register available | Adequate safe means of access into or egress provided |
Suitable & Sufficient lighting provided at workplaces) | tinuously within CS & at the place of work | Environment within the confined space is safe for entry & safe to work in |