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    Excavation Permit - PBC 78

    Uploaded by

    ROBIN GIBU
    This document is an excavation permit application for excavation work at the GEMS International School for the additional primary sport hall project. [1] It requests permission to excavate in a specified location and lists safety precautions that have been taken, including appointing a work-in-charge, locating underground utilities, using protective equipment, and removing excavated material safely. [2] The permit approving authority must inspect the work site and sign off that adequate safety measures are in place. [3] The permit is valid for a specified time period and work-in-charge must notify the approving authority once excavation is complete and the area cleared.

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    Excavation Permit - PBC 78

    Uploaded by

    ROBIN GIBU
    3 views1 page
    This document is an excavation permit application for excavation work at the GEMS International School for the additional primary sport hall project. [1] It requests permission to excavate in a specified location and lists safety precautions that have been taken, including appointing a work-in-charge, locating underground utilities, using protective equipment, and removing excavated material safely. [2] The permit approving authority must inspect the work site and sign off that adequate safety measures are in place. [3] The permit is valid for a specified time period and work-in-charge must notify the approving authority once excavation is complete and the area cleared.

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    This document is an excavation permit application for excavation work at the GEMS International School for the additional primary sport hall project. [1] It requests permission to excavate in a specified location and lists safety precautions that have been taken, including appointing a work-in-charge, locating underground utilities, using protective equipment, and removing excavated material safely. [2] The permit approving authority must inspect the work site and sign off that adequate safety measures are in place. [3] The permit is valid for a specified time period and work-in-charge must notify the approving authority once excavation is complete and the area cleared.

    Copyright:

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

    Excavation Permit - PBC 78

    Uploaded by

    ROBIN GIBU
    This document is an excavation permit application for excavation work at the GEMS International School for the additional primary sport hall project. [1] It requests permission to excavate in a specified location and lists safety precautions that have been taken, including appointing a work-in-charge, locating underground utilities, using protective equipment, and removing excavated material safely. [2] The permit approving authority must inspect the work site and sign off that adequate safety measures are in place. [3] The permit is valid for a specified time period and work-in-charge must notify the approving authority once excavation is complete and the area cleared.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Client: Consultant: Contractor:

    PROJECT:
    GEMS INTERNATIONAL SCHOOL, ADDITIONAL PRIMARY SPORT HALL
    EXCAVATION PERMIT
    Excavation Permit Company/Project /Site ……………………………………………………… Permit No. E-………….
    Section – I
    Location of the work :………………………………………………………………………
    (Attach sketch wherever possible)
    Description of the work :………………………………………………………………………
    Approximate duration of work : From……………………………To……………………….On ............................ (Date)
    Name of the work-in-charge :………………………………………………………………………
    Section - II
    Status
    No Check Points YES NO N/A
    1 Appoint Responsible Person supervising activities?
    2 Are the services (Cables, Pipelines etc.) are located/Marked?
    3 Whether using cable detector identified the existence of underground cables?
    4 Is clearance from local authorities/client obtained?
    5 Is pilot trench/Trial pit required? Only by hand tools
    6 Is Shoring or slopping required?
    7 Are the caution sign boards/Traffic signs/ warning light placed?
    8 Is barricades/handrails required?
    9 Is ladder (assess to the pit) required/cross over required?
    10 Excavated material removed or piled 1m away from embankment and not
    higher than 2m?
    11 All workmen are in possession of the PPE specified for job?

    Any other Precautions………………………………………………………………………………………………………………………………………….


    I request for an excavation permit for the above mentioned location, I have personally inspected the work place to
    ensure that the precautions mentioned above have been complied with. I will undertake to brief all workmen
    involved in the excavation activity about the hazards involved and precautionary measured.

    Signature of work-in-charge …………………………………………………….Date ……………………………………Time …………………….


    Section – III (Permit Approval) (Client approval shall be obtained wherever required)
    Work shall be carried out only after complying the precaution’s given in section II of this permit. (Approving
    authority shall check the adequacy of safety requirements mentioned in section II
    The permit is valid up to…………………………Hrs on……………………..
    Name of designated approving authority…………………………………………………
    Signature:………………………………………………Date………………………………..Time……………………………….
    Contractor Approval:
    Name …………………………………………………. Designation………………………………Sign………………………… Date&Time…………
    Section – V (Revalidation Details) Sign below in appropriate column to revalidate.
    SAT SUN MON TUE WED THU FRI
    Sign & Time
    Work-in-Charge
    Sign & Time
    Approving Authority
    HSE Approval
    Section – IV (Permit close out
    This work is completed and the area has been cleared. /Renewal of permit requested for an additional period of
    ………………………………………………….
    Work-in-charge Approving Authority
    Sign………………………………………………... Sign……………………………………………
    Date & Time ……………………………………... Date & Time…………………………………
    (To be returned to the designated approving authority after completion of work)

    PEPCO/HSE/PTW/E/R/001

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