ALANGHSE SERVICES PERMIT

ALANGHSE SERVICES

COLD WORK PERMIT

ALANGHSE-F-04
REV. 01
Controlled Form

SECTION 1: REQUISITION / CONTROL INFORMATION
Applicant (Mukadam)	VISHAL PANDEY	Ship Name	VISHAL PANDEY
Location / Work Description	[ CW_LOCATION ] - [ CW_DESC ]
Date / Issue Time	2026-08-10 / 08:00 AM	Valid Up to / Permit No.	08:00 AM / [ CW_PERMIT_NO ] A/B

SECTION 2: COMPLIANCE MATRIX
CHECK / CRITERIA	YES	NO	N/A	REMARKS
WORK AREA PREPARATION
1. Pre-job Meeting done?	☑			[ Q1_RMK ]
2. Gas Monitoring Required?	☑			[ Q2_RMK ]
3. Is there confined space areas?	☑			[ Q3_RMK ]
4. Is ventilation to the area adequate?	☑			[ Q4_RMK ]
5. Are lighting & access adequate?	☑			[ Q5_RMK ]
6. Emergency escape route marked?	☑			[ Q6_RMK ]
7. No hot work allowed in nearby area?	☑			[ Q15_RMK ]
EQUIPMENT & INFRASTRUCTURE
8. Firefighting equipment available?	☑			[ Q7_RMK ]
9. Oil Spill kit available before opening pipeline?	☑			[ Q8_RMK ]
10. Trolley available for material handling?	☑			[ Q12_RMK ]
11. Availability of Healthy tools?	☑			[ Q13_RMK ]
12. Inspection of chain block/rope?	☑			[ Q16_RMK ]
13. Inspection of safety harness?	☑			[ Q17_RMK ]
PERSONNEL & AUTHORIZATION
14. Permit for CS entry received from competent person?	☑			[ Q9_RMK ]
15. Trained worker?	☑			[ Q10_RMK ]
16. Are the workers in proper PPE?	☑			[ Q11_RMK ]
17. Barricade and proper signage displayed?	☑			[ Q14_RMK ]

SECTION 3: PPE + SECTION 4: EMERGENCY READINESS
☑ S.C.B.A set	☑ E.E.B.D	☑ First Aid Box	☑ Safety Helmet	☑ Multi-gas meter
☑ Cotton gloves	☑ Ear plug	☑ Safety Harness	☑ Wet Gel Blanket	☑ Fire Hose Standby
☑ Oil Spill kit	☑ Safety Shoes	☑ Fire Extinguisher	☑ Fire pump ready	☑ Ladder

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

GENERAL COLD WORK:
1. Never try to suppress a near miss; report it to HSE Manager.
2. Before opening pipelines/machinery, verify tools and status.
3. Hot work is strictly prohibited on pipelines under this permit.
LIQUID OXYGEN (LOX) SPECIFIC:
4. Maintain exclusion zone; declare NO SMOKING / NO HOT WORK.
5. Do not use oil/grease on LOX connections.
6. Monitor tank pressure (PG-1); do not exceed 15 kg/cm².

I have read and understood all instructions above and have explained them to all workers engaged in the work.

Mukadam Signature: _____________________ Date: 2026-08-10

SECTION 7: PERMIT RETURN
✓/X	STATUS	PERSON	NAME	SIGNATURE	TIME
☑	Permit is closed, job is completed	Mukadam	VISHAL PANDEY		08:00 AM
☑	Permit is closed, job is completed	Safety Officer	VISHAL PANDEY		08:00 AM

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