ALANGHSE SERVICES PERMIT

ALANGHSE SERVICES

HOT WORK PERMIT

HWP-04
REV. 01
Controlled Form

SECTION 1: REQUISITION / CONTROL INFORMATION
Date	2026-08-10	Applicant Name (Mukadam)	VISHAL PANDEY
Issue Time	08:00 AM	Ship Name	VISHAL PANDEY
Valid up to	[ HW_VALID ]	Location / Work Description	[ HW_LOC_DESC ]
Permit No. A/B	[ HW_PERMIT_NO ]	Name of Workers	VISHAL PANDEY
JHA Report No. (if any)	[ HW_JHA ]	Name of Attendant	[ HW_ATTENDANT ]
Permit No. (Ext. Competent Person)	[ HW_EXT_PERSON ]

SECTION 2: ASSOCIATED PERMITS + SECTION 3: ACTIVITY
☑ Confined space ☑ Safe for Entry (Vessel) ☑ Work at height ☑ Other: _________________	☑ Gas cutting ☑ Plasma cutting ☑ Welding ☑ Other: _________________

SECTION 4: COMPLIANCE MATRIX
CHECK / CRITERIA	YES	NO	N/A	REMARKS
WORK AREA & ENVIRONMENT
1. Pre-job Meeting done	☑			[ Q1_RMK ]
2. Gas Monitoring Required	☑			[ Q2_RMK ]
3. Is there confined space areas? If yes, permit no.	☑			[ Q3_RMK ]
4. Is ventilation to the area adequate?	☑			[ Q4_RMK ]
5. Are lighting & access to the work area adequate?	☑			[ Q5_RMK ]
6. Is the gas cutting hose and torch in good working condition?	☑			[ Q6_RMK ]
7. Equipment to check wind direction	☑			[ Q10_RMK ]
8. Emergency escape route is clean	☑			[ Q11_RMK ]
9. Is the adjacent area cleaned and gas free?	☑			[ Q12_RMK ]
10. Is there oily tank nearby?	☑			[ Q13_RMK ]
11. Adjacent space (oily) if oily, cleaning report to be prepared; if yes, report no.	☑			[ Q14_RMK ]
12. "Safe for hot work" sign displayed?	☑			[ Q15_RMK ]
EQUIPMENT & HOT-WORK CONTROLS
13. Is Flash back arrestor available in gas cutter?	☑			[ Q7_RMK ]
14. Cylinders are in upright condition	☑			[ Q8_RMK ]
15. Soap solution ready near to cylinders	☑			[ Q9_RMK ]
16. Equipment to check wind direction	☑			[ Q10_RMK ]
17. Is Block cleaned, clear of oil and other dangerous or flammable material?	☑			[ Q16_RMK ]
18. Cutting line is cleaned	☑			[ Q17_RMK ]
19. Crane is available to hold the block/section during its final cut - if yes, crane no.	☑			[ Q18_RMK ]
20. Removal of hazardous materials (as per IHM and PCHM) before commencing hot work	☑			[ Q19_RMK ]
21. Is hot work permit received from competent person?	☑			[ Q20_RMK ]
PEOPLE, PPE & AUTHORIZATION
22. Trained worker/Welder	☑			[ Q21_RMK ]
23. Are the gas cutters properly clothed and equipped?	☑			[ Q22_RMK ]
24. Dry surface, in case welding machine or plasma cutter is used	☑			[ Q23_RMK ]
25. Proper earthing before using plasma cutter or welding machine	☑			[ Q24_RMK ]

SECTION 5: PPE + SECTION 6: EMERGENCY READINESS
☑ S.C.B.A set	☑ E.E.B.D	☑ First Aid Box	☑ Cotton gloves	☑ Safety Helmet
☑ Coveralls	☑ Safety Shoes	☑ Ear plug	☑ Fire Hose Standby	☑ Fire Extinguisher
☑ Fire pump ready	☑ Cut resistant gloves	☑ Fire retardant suit	☑ Safety Goggles	☑ Filter mask
☑ Welding shield	☑ Stretcher	☑ Fire Blanket	☑ Fire suit

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 8: SPECIAL INSTRUCTIONS / ACKNOWLEDGEMENT

1. If "DO NOT ENTER" is displayed anywhere, never enter and do not allow anyone to enter without the required permit.
2. Never try to suppress/report a near miss yourself; immediately report it to the Safety Officer / HSE Manager.
3. Before cutting, check your torch nozzle and other items/equipment being used for the work.
4. Before starting cutting, check for leakage; start work only when no leakage is found.
5. If hot work is permitted and work is required in a confined space or at height, the Safe for Entry / Work at Height permit is mandatory.
6. Remove all flammable materials from the work area before starting hot work.
7. Return the permit to the Safety Officer / HSE Manager immediately after the work is completed.
8. Hot work is prohibited on any pipeline; action will be taken if this is violated.
9. Do not work at any location other than the location for which the permit has been issued.

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 9: PERMIT RETURN (PLEASE TICK WHERE APPLICABLE)
✓/X	STATUS	PERSON	NAME	SIGNATURE	TIME
☑	Permit is closed, job is contd. Please issue new permit	Mukadam	VISHAL PANDEY		08:00 AM
☑	Permit is closed, job is contd. Please issue new permit	Safety Officer	VISHAL PANDEY
☑	Permit is closed, job is completed	Mukadam	VISHAL PANDEY
☑	Permit is closed, job is completed	Safety Officer	VISHAL PANDEY
☑	Permit is cancelled, as present conditions are not conductive for carrying out the work

NOTE: Permit should not be closed until general housekeeping has been carried out, gas outlets are closed, residual gas has been removed from gas pipelines/hoses, and sections/blocks are in safe condition.

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

Note: SCBA - Self Contained Breathing Apparatus; EEBD - Emergency Escape Breathing Device; Ext. - External; No. - Number; JHA - Job Hazard Assessment.
This Permit is Valid for maximum 08 Hours including rest hours.

FORMAT PREPARED BY: HSE MANAGER APPROVED BY: GENERAL MANAGER