ALANGHSE SERVICES
REV. 01
Controlled Form
ALANGHSE SERVICES |
DE-BUNKERING PERMIT | ALANGHSE-F-05 REV. 01 Controlled Form |
| STEP 1: REQUISITION PERMIT IDENTIFICATION | |||
| Applicant (Mukadam) | VISHAL PANDEY | Ship Name | VISHAL PANDEY |
| Location / Work Description | [ DB_LOCATION ] - [ DB_DESC ] | ||
| Workers / Sub. Contractor | VISHAL PANDEY / [ DB_SUB_CONTRACTOR ] ([ DB_SUB_CONTACT ]) | ||
| Date / Issue Time | 2026-08-10 / 08:00 AM | Valid Up to / Permit No. | 08:00 AM / [ DB_PERMIT_NO ] A/B |
| STEP 2: ASSOCIATED PERMITS | |||
| Confined space permit | Safe for Entry (Vessel) | Work at height permit | Other: [ DB_AP_OTHER ] |
| STEP 3: PRE-WORK SAFETY VERIFICATION | |||||||
| CRITERIA | Y | N | N/A | CRITERIA | Y | N | N/A |
| 1. Is work permit for oil removal received from external competent authority? | ☑ |
16. Inspection of pipelines for damages/Joints/leaks done? | ☑ |
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| 2. Is the vessel securely moored? | ☑ |
17. Have drip trays been provided under joints? | ☑ |
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| 3. Job Hazard Assessment, if any? | ☑ |
18. Is there continuous supervision at inlet/outlet points? | ☑ |
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| 4. Availability of First Aid Kit and Oil Spill kit? | ☑ |
19. Have Oil tray placed below the pump with oil boom? | ☑ |
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| 5. Is oil boom wrap around hose intact? | ☑ |
20. Procedure for emergency shutdown and contact number in place? | ☑ |
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| 6. Gas Monitoring Required? | ☑ |
21. Has connection to the tank been properly secured and sealed? | ☑ |
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| 7. Is oil removal pump kept in confined space area? | ☑ |
22. Is the oil removal team trained? | ☑ |
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| 8. Is ventilation to the area adequate? | ☑ |
23. Are the workers in proper PPE? | ☑ |
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| 9. Are lighting and access/escape route adequate? | ☑ |
24. Availability of equipment in good condition? | ☑ |
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| 10. Housekeeping maintained and flammable materials removed? | ☑ |
25. Proper signage for warning/caution displayed? | ☑ |
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| 11. Fire fighting equipment available with fire team? | ☑ |
26. No hot work allowed in nearby area? | ☑ |
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| 12. Is portable fire extinguisher at pumping/filling station? | ☑ |
27. The Emergency Assembly Point identified? | ☑ |
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| 13. Has the method and clarity of communication been established? | ☑ |
28. Pre-job Meeting done? | ☑ |
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| 14. Inspection of all equipment’s including pumps done? | ☑ |
29. Induction training provided to oil removal truck drivers? | ☑ |
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| 15. Are electric cables proper insulated? | ☑ |
30. Is oil loading area barricaded and stoppers provided for trucks? | ☑ |
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| STEP 4: PPE / EMERGENCY READINESS | |||
☑ Safety Helmet |
☑ Dust mask |
☑ S.C.B.A set |
☑ E.E.B.D |
☑ Coveralls |
☑ Cotton gloves |
☑ Stretcher |
☑ Fire suit |
☑ Harness (truck) |
☑ Latex gloves |
☑ Fire Blanket |
☑ First Aid Box |
☑ Filter mask |
☑ Safety Goggles |
☑ Fire Extinguisher |
☑ Fire Hose |
☑ Ear plug |
☑ Disposal suit |
☑ Sand bucket |
☑ Wet Gel Blanket |
☑ Safety Harness |
☑ Mech. Blowers |
☑ Ladder |
☑ Rope |
| STEP 5: JOINT INSPECTION / AUTHORISATION | ||
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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 / Yard Supervisor Signature: |
APPROVAL BY HSE DEPARTMENT
I am satisfied with safety precautions and hereby give permission to commence work.
Name: VISHAL PANDEY
Designation: Safety Officer / HSE Manager Signature: |
PERMIT CONTROLLER / PM-GM
Approval by Plot Manager (PM) / General Manager (GM).
Name: VISHAL PANDEY
Designation: PM/GM Signature: |
| STEP 6: SPECIAL INSTRUCTIONS / MUKADAM ACKNOWLEDGEMENT |
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1. अगर कहीं भी DO NOT ENTER लिखा हुआ हो तो कभी भी अन्दर न जाये और नाही किसी को जाने दे जब तक आपके पास परमिट न हो| 2. नियर मिस कभी भी छुपाने की कोसिस न करे उसे फौरन सेफ्टी ऑफिसर को रिपोर्ट करे | 3. पाइपलाइन/मसिनेरी पार्ट्स खोलने से पहले अपने टूल्स और अन्य वास्तु को चेक करना जरुरी है | 4. अगर आपको डी बंकरिंग परमिट मिल गया है और कहीं बंद जगहे में काम करना हो तो बंदस्थान की अलग से अनुमति लेना आनिवार्य है| 5. किसी भी टैंक की सफाई करने से पहले बंदस्थान की अनुमति परमिट लेना आनिवार्य है | Mukadam acknowledgement: I have read, understood and explained these instructions to all workers. Signature: _____________________ Date: 2026-08-10 |
| STEP 7: PERMIT RETURN | |||||
| ✓/X | STATUS | PERSON | NAME | SIGNATURE | TIME |
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Permit is closed, job 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 |