ALANGHSE SERVICES PERMIT

ALANGHSE SERVICES

BOAT EMBARKATION PERMIT

ALANGHSE-F-07
REV. 01
Controlled Form

SECTION 1: REQUISITION PERMIT IDENTIFICATION
Applicant (Mukadam)	VISHAL PANDEY	Ship Name	VISHAL PANDEY
Location of Embarkation	[ BE_LOC_EMB ]	Location of Disembark	[ BE_LOC_DISEMB ]
Workers / Passengers	VISHAL PANDEY
Date / Issue Time	2026-08-10 / 08:00 AM	Valid up to / Permit No.	08:00 AM / [ BE_PERMIT_NO ] A/B
JHA No. (If any)	[ BE_JHA_NO ]

SECTION 2: ASSOCIATED PERMITS
☑ Safe for Entry (Vessel)	☑ Debunkering Permit	☑ Cold work permit	☑ Other: [ BE_AP_OTHER ]

SECTION 3: WORK SITE PREPARATION / PRECAUTIONS SPLIT CHECKLIST
CRITERIA	Y	N	N/A	CRITERIA	Y	N	N/A
1. Boat ride plan discussed with GM, Mukadam, HSE one day in advance?	☑			15. Is proper access ladder provided to board the boat and the ship?	☑
2. Required to notify the Marine Police about the ride?	☑			16. Are all the moving parts of the boat secured?	☑
3. HSE member and supervisor clearly identified?	☑			17. Is the fuel and lube oil check has been carried out?	☑
4. Tide-tables available with Mukadam & boat operator?	☑			18. Is any oil leakage visible in the boat?	☑
5. Primary & secondary comms agreed (Mobile/Walkie)?	☑			19. Are all personnel in the boat ride wearing the life jacket?	☑
6. Wind speed, sea state and weather forecast checked?	☑			20. Emergency contact numbers placed in boat and Embarkation Points?	☑
7. Clean landing area identified on both sides?	☑			21. Ensured that maximum occupancy of boat has not been crossed?	☑
8. Is embarkation zone kept clear of any obstacles?	☑			22. Passengers in designated space so balance is maintained?	☑
9. Area clear and ongoing work stopped in inter-tidal area?	☑			23. Waterproof bags provided for carrying belongings?	☑
10. Personnel having 2 ID cards, stand at embark point?	☑			24. Trained First aider available in boat with first aid kit?	☑
11. Security available on both sides for head counting?	☑			25. Food and water arranged for all onboard?	☑
12. Rescue boat equipped with Life Saving Appliances/Crane?	☑			26. Timing of return boat ride informed to all personnel?	☑
13. De-briefing done before the boat ride operation?	☑			27. Is the permit displayed near the Embarkation point?	☑
14. Passengers briefed on safety rules, smoking ban, balance?	☑

SECTION 4: PPE				SECTION 5: EMERGENCY ITEMS
☑ Safety Helmet	☑ Safety Shoes	☑ Ear plug	☑ Dust mask	☑ Spare Life jacket	☑ First Aid Box	☑ Pair of Oars	☑ Rescue boat
☑ Safety Goggles	☑ Cotton gloves	☑ Coveralls	☑ Life Jacket	☑ Life buoy	☑ Rope	☑ Fire Extinguisher	☑ Crane

SECTION 7: JOINT INSPECTION - APPROVAL SEQUENCE
A. PERMIT APPLICANT I am satisfied that all precaution has been taken and all safety arrangements will be maintained for entire duration of work. Name: VISHAL PANDEY Designation: Ship Supervisor / Yard Supervisor Signature	B. HSE APPROVAL I am satisfied with safety precautions and hereby give permission to commence work. Name: VISHAL PANDEY Designation: Safety Officer / HSE Manager Signature	C. PERMIT CONTROLLER / PM-GM Approval by Plot Manager (PM) / General Manager (GM). Name: VISHAL PANDEY Designation: PM/GM Signature

SECTION 7: SPECIAL INSTRUCTIONS

1. नियर मिस कभी भी छुपाने की कोसिस न करे, उसे फौरन सेफ्टी ऑफिसर/HSE प्रबंधक को रिपोर्ट करे
2. जहाज से वापिस आने के तुरंत बाद परमिट सेफ्टी ऑफिसर/HSE प्रबंधक को लौटा दे!
3. यदि कोई उचित तर्क के साथ असुरक्षित महसूस करता है तो यात्रा रद्द कर दें

SECTION 8: PERMIT RETURN
✓/X	STATUS	PERSON	NAME	SIGNATURE	TIME
☑	Permit is closed, ride is completed	Mukadam	VISHAL PANDEY		08:00 AM
☑	Permit is closed, ride is completed	Safety Officer	VISHAL PANDEY		08:00 AM

SECTION 10: EMERGENCY CONTACT NUMBERS
SL. NO.	NAME	DESIGNATION	CONTACT NO.
1	ROCKY SINGH	HSE MANAGER	7990404108
2	PRAVIN SHIYAL	PLOT MANAGER	79846 07070