ALANGHSE SERVICES
REV. 01
Controlled Form
ALANGHSE SERVICES |
SAFE FOR ENTRY PERMIT | ALANGHSE-SFE-01 REV. 01 Controlled Form |
| SECTION 1: REQUISITION / CONTROL INFORMATION | |||
| Ship Name | VISHAL PANDEY | Time of Check | 08:00 AM |
| Date / Issue Time | 2026-08-10 / 08:00 AM | Valid till / Permit No. | [ SE_VALID_TILL ] / [ SE_PERMIT_NO ] A/B |
| JHA Report No. | [ SE_JHA ] | Ext. Competent Person Permit No. | [ SE_EXT_PERMIT ] |
| SECTION 2: GAS READINGS & EQUIPMENT | SECTION 3: LOCATION FOR SAFE ENTRY | ||||
O2[ GAS_O2 ] |
LEL[ GAS_LEL ] |
CO[ GAS_CO ] |
H2S[ GAS_H2S ] |
☑ Forepeak tank |
☑ Engine room |
☑ Upper/main deck |
☑ Void Space no. ☑ |
||||
| Meter: MSA ALTAIR 4X / GMI PS 241 | Other/Blocks: ☑ ☑ | ||||
| SECTION 4: COMPLIANCE MATRIX | ||||
| CHECK / CRITERIA | YES | NO | N/A | REMARKS |
| ACCESS & BARRICATION CONTROLS | ||||
| 1. Safe for Entry Tag/board displayed near ladders. | ☑ |
[ Q1_RMK ] | ||
| 2. Access is restricted and barricaded if not safe. | ☑ |
[ Q3_RMK ] | ||
| 3. Temporary holes on floor are covered/barricaded. | ☑ |
[ Q7_RMK ] | ||
| 4. Valid certificates of access ladders are displayed. | ☑ |
[ Q9_RMK ] | ||
| 5. Open edges are barricaded at least 1m away. | ☑ |
[ Q14_RMK ] | ||
| 6. Temporary ladders are tied on both sides. | ☑ |
[ Q16_RMK ] | ||
| ENVIRONMENT & EQUIPMENT CHECKS | ||||
| 7. Illumination >= 60 lux. | ☑ |
[ Q4_RMK ] | ||
| 8. Temperature <= 45°C. | ☑ |
[ Q5_RMK ] | ||
| 9. Wind speed <= 35 km/hr. | ☑ |
[ Q12_RMK ] | ||
| 10. Continuous power supply & backup available. | ☑ |
[ Q15_RMK ] | ||
| 11. Escape route free from obstacles. | ☑ |
[ Q13_RMK ] | ||
| EMERGENCY PREPAREDNESS & PERSONNEL | ||||
| 12. Marking of assembly area & escape route. | ☑ |
[ Q2_RMK ] | ||
| 13. Display of emergency contact near accesses. | ☑ |
[ Q6_RMK ] | ||
| 14. Head count system/worker tracking in place. | ☑ |
[ Q8_RMK ] | ||
| 15. Emergency response team members contact displayed. | ☑ |
[ Q10_RMK ] | ||
| 16. Availability of emergency items near assembly area. | ☑ |
[ Q11_RMK ] | ||
| SECTION 5: EMERGENCY READINESS & EQUIPMENT | ||||
☑ SCBA sets (04) |
☑ EEBD (04) |
☑ Fire Pumps (2) |
☑ Fire Hoses (>=200m) |
☑ Spare Safety Harness (>=4) |
☑ Fall Arrestor (1) |
☑ Tripod (1) |
☑ Emergency Siren (1) |
☑ Fire Blanket (1) |
☑ Sand Buckets (>=4) |
☑ First Aid Box (1) |
☑ Stretcher (1) |
☑ Pilot ladder (2) |
☑ Fire Suits (2) |
☑ Fire Extinguishers (>=4) |
| 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. Safe for Entry Tag must be strictly obeyed. Do not enter without valid authorization. 2. Verify emergency escape routes are clear before commencing any work. 3. In case of mechanical system failure or general lighting system failure, the Safety Officer / HSE Manager shall be re-called, and the “Entry Permit” shall become void. 4. Maintain continuous tracking of personnel utilizing the Head Count System.
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 | |||||
| ✓/X | STATUS | PERSON | SIGNATURE | TIME | |
☑ |
This Permit is closed and new safe for entry (ship) [ SE_NEW_PERMIT ] has been issued. | Safety Officer | 08:00 AM | ||
☑ |
This Permit is closed/cancelled and all the persons have dis-embarked form the ship. | Safety Officer | 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 |