Turbine Boiler Electrical I&C BoP Coal handling Hot work
Work permit No. ______________________
1. Equipment name and KKS:
___________________________________________________________________________________________________________________________ 2. Work content and scope :____________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ 3. Work responsible person: _______________________________________________________ /signature /date/time Members of work team: _____________________________________________________________________________________________________________ Total ____ persons. Apply scheduled time from: ____________________________________ to ______________________________________ /date/time 4. Approve scheduled time from: ____________________________________ to ______________________________________ /date/time DEC Shift leader: ________________________________________ /signature EFT Shift leader: _______________________________________ /signature 5. Measures for safe work: Mechanical:_______________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ Electrical:_________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ I&C:______________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ Hot work content (if necessary): ______________________________________________________________________________________________________________________ Measures for hot work: ______________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ If there is work in primary hot work area, it should be approved by senior managers. DEC Senior managers: _____________________________ /signature /date/time EFT Senior managers: _____________________________ /signature /date/time 6. Measures reviewed by work permit issuer: ___________________________ date ___________ time ______________ 7. Measures and operations completed, with No Operation tags placed Mechanical: ___________________________________________________________________________ Done by _______________________ /signature /date/time Electrical: _____________________________________________________________________________ Done by _______________________ /signature /date/time I&C: __________________________________________________________________________________ Done by _______________________ /signature /date/time Hot work (if necessary): __________________________________________________________________ Done by _______________________ /signature /date/time Additional measures (if necessary): ____________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________ Done by _______________________ /signature /date/time 8. All necessary safety measures above (including supplementary part) have been properly executed and confirmed by work approver as well as work responsible person on site. The work is permitted to start from ___________________________ /date/time. Work approver: _________________ /signature EFT shift leader: ___________________ /signature Work responsible person: __________________ /signature 9. Extending work time to __________________________ /date/time (if necessary) DEC shift leader: _________________ /signature EFT shift leader: ___________________ /signature Work responsible person: __________________ /signature 10. Work finished, tools and workers removed from the site, and the site has been cleaned. All work is finished at __________________________ /date/time. Work responsible person: _________________________ /signature Work approver: ____________________________ /signature 11. Measures from item No.5 set in original (working) condition and No operation tags removed: Mechanical: Done by _____________________________ /signature /date/time Electrical: Done by _____________________________ /signature /date/time I&C: Done by _____________________________ /signature /date/time 12. Reviewed and closed: DEC Shift leader: ________________________________ /signature EFT shift leader: ________________________________ /signature