Nokia Solutions & Networks

Country & Business India, Global Services

No. & Concerns : F-01 (OCP-003) & Permit for Working at Heigt
Rev. No. & Issue Date 00 & 01.06.10
1! P"#$%& NO'
(ali) From (*ate+&ime)' (ali) ,-to (*ate+&ime)'
.! Site %*+Site *etail+ /o0ation of Work'
3! *"SC#%P&%ON OF WO#1 &O 2" C3##%"* O,&'
4! H353#*S 3SSOC%3&"* W%&H &H%S WO#1 (lease Identi!y usin" #IR$%
6! CON&#O/ $"3S,#"S &O 2" %$P/"$"N&"*
S!N %&"$ 7es No #emarks
1 Is t&e 'erson aut&orised, co('etent & trained to )or* at
&ei"&t
+ Is t&e sco'e o! )or* to be carried out at &ei"&t is *no)n
and understood.
, Ris* assess(ent conducted- Ris* evaluated
. Double lanyard !ull body Sa!ety &arness secured to a
!i/ed structure - stron" anc&orin" 'oint. $ll ot&er 0 as
re1uired is bein" used.
2 Sa!ety net available- Steel sca!!oldin" - 'lat!or( ri"&tly
erected - is bein" used. 3 4nly !or ro5ect 6ana"e(ent
Sco'e i.e. su'ervision%
6 Sa!e access to )or* 'lace - )or*in" 'lat!or( )it&
&andrails and toe "uard 'rovided.
7 Is t&e area cordoned o!!-barricaded
8 Nearest 0(er"ency Contact Detail available )it& tea(.
9 Is ener"y Isolation re1uired
10 $de1uate li"&tin" and all re1uire(ents !or ni"&t )or*in"
'rocedures !ollo)ed and 'rovided.
11 Is activity bein" carried out in t&e 'resence o! a NSN
en"ineer or t&e 'resence o! su'ervisor re1uired:
8! "N*O#S"$"N&
I &ave understood t&e nature and e/tent o! t&e )or*. I a"ree to co('ly )it& all sa!ety 'recautions
Name Signature *ate &ime
Permit #e0ei9er
Permit %ssuer
Com-letion of Work' ($ll sa!e"uards returned to nor(al-$ny ot&er ;eedbac*-Co((ents :
%ssuer Signature & Name
a"e<1 Docu(ent 4)ner & De'art(ent Controlled
Services 4#S De'art(ent