INDIAN OIL CORPORATION LIMITED
WORK PERMIT (For issue by RO Manager or Dealer)
Serial No IOCL/1400/1407/U27/1-1024048749041
Name of RO/Location RAJ KUMAR FILLING STATION / KANPUR NAGAR
Valid From 27-02-2024 01:34:25 PM Valid To 27-02-2024 02:36:34 PM
Permission is granted to section or contractor GILBARCO VEEDER ROOT INDIA PRIVATE / Mukul Bhatt
Nature of Work ROVs Maintenance
Nature of Work in Detail for which this work
NOZZLE
permit is valid
Location of Work (specific area inside the RO) DU AREA
Complaint Type DU eCTS
Complaint No./Approval No. 3715758
Complaint Date/Approval Date 27-02-2024
Complaint Description/Approval Comments NOZZLE
Vendor Authorized Person
First Name MANISH Last Name SINGH
Date of Birth 01-06-1975 Gender Male
Mobile 7007292548 Email [Link]@[Link]
Dealer Authorized Person
First Name NITIN KUMAR Last Name Pal
Date of Birth 14-05-1978 Gender Male
Mobile 9889315994 Email knpranchi111@[Link]
The following items shall be checked before issuing the permit:
[Link]. Item Status
1 Equipment / Work Area inspected Yes
2 Surrounding area checked, cleaned and covered Yes
3 Equipment electrically isolated and tagged
3.1 Dispensing Unit Yes
3.2 DG Set NA
3.3 RVI Elements (Monolith , Fascia and Spreaders ) NA
3.4 Compressor NA
3.5 Servo Stabiliser/ CVT NA
3.6 Batteries NA
3.7 Canopy Lights / Yard Lights NA
3.8 Other Electrical equipments Yes
3.9 U/G Electrical Cables Yes
4 Running water hose / Portable extinguisher provided. Yes
5 Equipment blinded / disconnected / closed / isolated /wedge opened
5.1 U/G product Storage Tank NA
5.2 Dispensing unit Yes
5.3 Product Pipeline and Vent Pipes Yes
5.4 Air Compressor NA
5.5 DG Set NA
6 Standby personnel provided Yes
7 Availibility of standard equipment during execution of work Yes
8 Usages of full body Safety harness and anchorage while working at height > 2 Meters Yes
9 Presence of live U/G electrical Cables before start of Excavation work Yes
10 Work does not involve direct contact with product/product vapours Yes
11 Work does not involve any activity capable of producing spark in hazardous area Yes
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INDIAN OIL CORPORATION LIMITED
12 Work not being executed beyond 2 meter height Yes
SPECIAL INSTRUCTIONS
1. Following personal protection equipment are required (check all items required) existing list of PPE plus one more item "Safety
Harness" to be added in the list:
Safety Helmet
Gloves
Goggles
Safety Shoes
Apron / Lifeline
2. In case of fire alert, all work must be stopped. All personnel must leave work site and proceed to designated or on site directed areas.
3. Remarks on toxic/hazardous chemicals, if any:
4. Alternate means of escape: Not Required
5. This permit must be available at work site at all times.
6. Additional items, if any:
GILBARCO VEEDER ROOT INDIA
RAJ KUMAR FILLING STATION PRIVATE
(Signature)
(Signature) Mukul Bhatt
Dealer or Authorized Manager Contractor or Authorized Supervisor
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