PTW – demolition work permit

Magicsoft Asia night

PROJECT :

DEMOLITION WORK 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

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 barriers & warning signs erected to prevent unauthorised entry Yes

Adequate safe access provided for workers access to workplaces Yes

Safe work platform provided i.e. Min 500mm wide/ secured & of sound materials Yes

Adequate edge protection provided – top rail/ mid rail/ toe board (Top rail ≥ 1m high / mid rail < 0.6m high / toe board ≥ 90mm high) Yes

Overhead protection/ debris netting provided Yes

Demolition work properly scheduled to minimize inconvenience to public/tenant Yes

Existing affected services identified & terminated or diverted & protected Yes

Adequate lighting provided at workplaces Yes

applicant/ SC Engr/ Sup to provide continuous monitoring & supervision on site Yes

Competent Operator/ worker appointed & briefed on sequence of work Yes

Regular removal of demolition debris to prevent overloading of structures Yes

Safe access for machinery identified & demarcated on site Yes

PE Design Calculation/ Drawings/ COS available for removal of load bearing structures 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