ALANGHSE SERVICES
REV. 01
Controlled Form
ALANGHSE SERVICES |
BOAT EMBARKATION PERMIT | ALANGHSE-F-07 REV. 01 Controlled Form |
| SECTION 1: REQUISITION / CONTROL INFORMATION | |||
| Applicant (Mukadam) | VISHAL PANDEY | Ship Name | VISHAL PANDEY |
| Loc of Embarkation | [ BE_LOC_EMB ] | Loc 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 |
| SECTION 2: COMPLIANCE MATRIX | ||||
| CHECK / CRITERIA | YES | NO | N/A | REMARKS |
| PRE-RIDE PLANNING & COMMUNICATION | ||||
| 1. Boat ride plan discussed with GM/HSE/Mukadam? | ☑ |
[ Q1_RMK ] | ||
| 2. Required to notify Marine Police about ride? | ☑ |
[ Q2_RMK ] | ||
| 3. Tide-tables available with Mukadam & operator? | ☑ |
[ Q4_RMK ] | ||
| 4. Primary/secondary comms tested (Walkie/Mobile)? | ☑ |
[ Q5_RMK ] | ||
| 5. Wind speed, sea state, forecast checked? | ☑ |
[ Q6_RMK ] | ||
| 6. Timing of return ride informed to all personnel? | ☑ |
[ Q26_RMK ] | ||
| SITE CLEARANCE & ACCESS | ||||
| 7. Clean landing area identified on both sides? | ☑ |
[ Q7_RMK ] | ||
| 8. Embarkation zone kept clear of obstacles? | ☑ |
[ Q8_RMK ] | ||
| 9. Inter-tidal area clear & ongoing work stopped? | ☑ |
[ Q9_RMK ] | ||
| 10. Is proper access ladder provided to board the boat and the ship? | ☑ |
[ Q15_RMK ] | ||
| 11. Permit displayed near the Embarkation point? | ☑ |
[ Q27_RMK ] | ||
| BOAT CONDITION & LOAD CONTROLS | ||||
| 12. Are all the moving parts of the boat secured? | ☑ |
[ Q16_RMK ] | ||
| 13. Is the fuel and lube oil check has been carried out? | ☑ |
[ Q17_RMK ] | ||
| 14. Is any oil leakage visible in the boat? | ☑ |
[ Q18_RMK ] | ||
| 15. Max occupancy of the boat not crossed? | ☑ |
[ Q21_RMK ] | ||
| 16. Passengers in designated space for balance? | ☑ |
[ Q22_RMK ] | ||
| PASSENGER SAFETY & AUTHORIZATION | ||||
| 17. HSE team member & supervisor clearly identified? | ☑ |
[ Q3_RMK ] | ||
| 18. Personnel having 2 ID cards, stand at embark pt? | ☑ |
[ Q10_RMK ] | ||
| 19. Security available on both sides for head counting? | ☑ |
[ Q11_RMK ] | ||
| 20. Rescue boat equipped with Life Saving Appliances/Crane? | ☑ |
[ Q12_RMK ] | ||
| 21. De-briefing done before boat ride operation? | ☑ |
[ Q13_RMK ] | ||
| 22. Passengers briefed on safety, smoking ban, balance? | ☑ |
[ Q14_RMK ] | ||
| 23. Are all personnel in boat wearing life jacket? | ☑ |
[ Q19_RMK ] | ||
| 24. Emergency contacts placed in boat & Embark Points? | ☑ |
[ Q20_RMK ] | ||
| 25. Waterproof bags provided for carrying belongings? | ☑ |
[ Q23_RMK ] | ||
| 26. Trained First aider available in boat with first aid kit? | ☑ |
[ Q24_RMK ] | ||
| 27. Food and water arranged for all onboard? | ☑ |
[ Q25_RMK ] | ||
| SECTION 3: PPE + SECTION 4: EMERGENCY READINESS | ||||
☑ Spare Life jacket |
☑ Life buoy |
☑ First Aid Box |
☑ Safety Helmet |
☑ Safety Goggles |
☑ Safety Shoes |
☑ Cotton gloves |
☑ Ear plug |
☑ Coveralls |
☑ Rope |
☑ Pair of Oars |
☑ Fire Extinguisher |
☑ Rescue boat |
☑ Crane |
☑ Dust mask |
| SECTION 7: JOINT INSPECTION & AUTHORISATION MATRIX | ||
| A. PERMIT APPLICANT | B. HSE APPROVAL | C. PERMIT CONTROLLER / PM-GM |
|
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 / Yard Supervisor Signature: |
I am satisfied with safety precautions and hereby give permission to commence work.
Name: VISHAL PANDEY
Designation: Safety Officer / HSE Manager Signature: |
Approval by Plot Manager (PM) / General Manager (GM).
Name: VISHAL PANDEY
Designation: PM/GM Signature: |
| SECTION 6: SPECIAL INSTRUCTIONS / ACKNOWLEDGEMENT |
|
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
I have read and understood all instructions above and have explained them to all workers engaged in the work. I will ensure compliance until the work is completed.
Mukadam Signature: _____________________ Date: 2026-08-10 |
| SECTION 7: PERMIT RETURN | |||||
| ✓/X | STATUS | PERSON | NAME | SIGNATURE | TIME |
☑ |
Permit is closed, ride is completed | Mukadam | VISHAL PANDEY | 08:00 AM | |
| Safety Officer | VISHAL PANDEY | ||||
| SECTION 10: EMERGENCY CONTACT NUMBERS | |||
| SL. NO. | DESIGNATION | NAME | CONTACT NO. |
| 1 | HSE MANAGER | ROCKY SINGH | 7990404108 |
| 2 | PLOT MANAGER | PRAVIN SHIYAL | 79846 07070 |