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Permit To work Form-Contractor & Department(1).pdf

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  • PERMIT TO WORK FORM

    1. NAME OF COMPANY ____________________________________ APPLY DATE: ________ 2. ADDRESS/ OFFICE: ____________________________________

    ____________________________________ 3. TELEPHONE NO ____________________________________

    4. LOCATION OF WORK: ____________________________________

    ____________________________________

    5. WORK DATE: _________________________ WORK TIME:_______________________

    6. NATURE OF WORK: ____________________________________ ____________________________________ ____________________________________

    7. EVENT NAME (As per Event Order): ______________________________

    8. EVENT DATE: ________________________ EVENT TIME: ______________________

    NO 9. WORKERS NAME IC NO PASS NO SIGNATURE 10. DECLARATION OF ITEMS BRING IN & OUT

    TOOLS CHEMICALS NO TOOLS NO CHEMICAL VOL (IN) VOL (OUT) MSDS RULES & REGULATIONS

    1. Contractors must wear proper attire (no slipper, singlet and short) 2. All equipment must be in a good condition and free from any fire and safety hazards. 3. Contractors must bring and place the safety signboard at their working area. 4. Please refer to contractor safety manual for more details regarding safety procedure. 5. No sharp or dangerous tools to be lying around unattended. 6. The wall, floor and carpet must be protected from dirt, spillage of chemical/ paint,

    cement or water. I/We confirm that we read and understood fully the terms and conditions as stated in the CONTRACTOR CONTROL PROCEDURE and hereby agree to abide strictly and fully by the rules and regulations as set by the Grand Hyatt Kuala Lumpur pertaining to the above application.

    Acknowledged by (GHKL): ---------------------------------- Department Concern Name : Date : H/P no : .

    Agreed by (Client/Vendor): --------------------------------- Contractor Manager/Supervisor Name : Date : H/P no : ...

    Approved by (GHKL): -------------------------------------- Director of Engineering Name : Date :

    Acknowledged by (GHKL): ------------------------------------ Director of Security Name : Date :

    Lokman Razani Abdul RazakText