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Diving Work Permit Form

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DIVING WORK PERMIT

Project Name PANGUIL BAY BRIDGE PROJECT Date

Detailed Location:

Work Description:

Section – I DETAILS OF THE PERMIT REQUESTOR (SC

Permit Requestor Signature

Responsible Engineer Signature

Name of the Diver Head Signature

EHS In Charge Signature

Section – II PERMIT VALIDATIONS & CLOSURE

Start Work From Date / / Time : To Date / / Time :


Extend Work From Date / / Time : To Date / / Time :

From Date / / Time : To Date / / Time :

Section – III PREREQUISITE (Work can be stopped if one of the followings is not complied with)
Yes No NA Yes No N
A Method Statements & JSEA provided? J Stand by Diver dressed?

Two way communication established


B Equipment/system isolated and locked out and K
and known?
tagged out (LOTO)?
Emergency communication
C Wind/Waves checked? L
maintained available?
Emergency transportation
D Velocity and direction of the current confirmed? M
maintained ready?
Compressor for respiratory air
E In-water Visibility checked? N
chcecked?
An air flow meter provided and
F Diving equipment checked? O
properly function?
Watch man (look out) assigned and
G Depth guage properly calibrated as required? P
maintained?
Search light furnished for
H Diving record/Log maintained? Q
emergency?
Life Jackets available and worn by
I Diving dresses free of defects? R
all crew?
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Details of employee working in the 2 6


water
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