SmartCheck | COMPUTERISED MAINTENANCE MANAGEMENT SYSTEM

Raise WorkPermit

Permit Requester^*

WorkPermit Type^*

Details of Description of Work:^*

Exact Location of Work:^*

Date of Submission:^*

Time

Expected Duration of Work

Start Date:^*

End Date:^*

Requested Time for Work:^*

(Note: Preferably all work shall be Mall Non-Operational Hours only)

Dept./Brand/Contractor Details

Organization/Department:^*

Brand/Shop Name:^*

Name of Contact Person^*

Mobile No^*

Emergency Contact^*

ID No/SSN No/PAN Card No^*

Address^*

Contractor Detail (Who do the execution of work)

Company Name:^*

No. of Workers:^*

Contact Person Name:^*

Contact Number:^*

Workers Name List:^*

Documents to be Enclosed

Plan /Drawing Submission

Workman Compensation

Retailer Indemnity

Contractor Indemnity

Hazard Identification and Risk Assessment(General) and Safety Plan/Instructions (To be evaluated by an expert of Job initializing/Executing Department) (Mark off the considerable factors in each title)

Risk Identified

Body Injury/Scratch

Collision with vehicle

Tripping/Sliding/Fall of man/material

Accidental fall of human

Damage to buried cables

Fire/Burns

Electrical Shock

Explosion

Suffocation

Poisoning

Impact to other installations

Dust emission

Engineering Control

Usages of appropriate and fully serviceable equipment/tools

Regular Maintenance and periods cheeks of equipment

Suitable Communication Device

Administrative Control

Work carried out/supervised by competent and authorized person

Strict adherence to SOP

Dont't walk in unauthorized area

Safety briefing (tool box talk)

Proper maintaince of equipment

maintenance record

Reliable equipement's

Antiskid arrangements

Trained man power

Staff understand their duties and responsibility

Availability of suitable fire appliances

Barrieading/Safety warning

Shutter,Safety warning

Emergency awareness procedures

Comply to real time work instruction

Essential phone No.with work sup for emergency use

Fire Extinguishers

PPE

Helmets

Eye Protection

Ear Plugs

Safety Hamess

Bad wether lothings

High vis jacket

Appropriate Gloves

Safety shoes

Illumination

protective Clothing

Hand protection/Gloves

Face shield

Dust/Mouth Mask

Full Body Hamess

Note: An adequate Risk Assessment of the activity carried out for applying the neccessary mitigation measures to minimize the potential risk.The risk level for HIRA (general) is to be declared after considering the implementation of Engineering control,Administrative control and PPE for the identified risk. A seperate detailed 'Safety Assessment' should be prepared for any major change in facility/major work.I have read and understand all the aspect of Terminal Works Procedure and undertake to brief and ensure compliance by all concern(Job executing team/supervisors)to abide by the above mentioned safety requirement.

Risk Factor
Acceptable/Not Acceptable

HIRA Prepared By(Job Initiator and Job Executer)
Name:		Date:^*

HIRA Reviewed By(Safety Department)
Name:		Date:

BY THE RETAILER/AGENCY/COMPANY/VENDOR
Name:

The operations department will only allow the work to happen after authorization from the security department.
Retailers Relations		Ops Manger
Manager - Loss Prevention		Sr. Marketing Manager
Finance Manager		Finance Manager
Chief Engineer		Sr. Manager Operation
General Manager

General Do's and Don'ts
SAFETY PRECAUTIONS REQUIRED
1. Safety clearance form should be pasted on work site with labor list & indemnity. 2. Duplicate key of work site should be available at mall security (Applicable for board out work site) 3. The Contractor should start work only after the site is safe for work. 4. Physical fitness is must for all workers. 5. No cooking or sleeping, No Smoking, No Spitting, No washing, is allowed in the premises as anytime. 6. No usage of any kind of alcohol, cigarettes, pan, and tobacco permitted in work area 7. No smoking signage should be displayed at work site. 8. Labour to be aware of Basic Safety, First aid, Emergency exits and Emergency Contact numbers.
Access Movement
1. No work should happen in customer area between 10am to 11pm (MOD may permit). 2. No Labor movement in customer area during trading hours. 3. No disturbance should be caused to customer. 4. Identity card to be issued by Contractor & Site Card by Inorbit Malls (Vashi). 5. Emergency numbers should be visible on work site. 6. All workers should carry / Display carries ID cards. 7. Only Mentioned workers in security clearance are allowed to work. 8. Contractors have to submit labor list with their residential address & contact Numbers of relatives.
Mandatory safety Measures
1. Safety signage should be properly displayed at all work sites. 2. Emergency light required at work site (Applicable for board out work site). 3. Safety Helmets to be worn (Mandatory for any work at 10 ft Height & Above). 4. Safety Harness to be worn (Mandatory for any work at 10ft Height & Above). 5. All ladders used for the work to be in good condition.(only aluminum ladders). 6. Required footwear to be worn while performing work in the Mall.(to be decided by nature of work ). 7. Fire extinguishers should be available at all work sites (Minimum 5Kg, DCP-Type). 8. Emergency Medical Kits to be available all work site. 9. Work site should be kept combustibles free. Proper storage closets for combustible and hazardous material should be maintained. 10. Fire exit to be kept free from obstruction.
Civil safety measures
1. A 35-foot safe zone in all directions from the welding area must be maintained by covering all combustibles with non-combustible material or removing them. 2. If any work happens at a height of 20ft or above then a security guard to be deployed. 3. Any modification to the sprinkler to be notified to MOD in advance to isolate and depressurize the system. Proper cover of the sprinklers to be fixed to the sprinkler vials. 4. Adequate ventilation to be maintained at work site.
Electrical safety measures
1. Electrical equipments should be in proper working condition. 2. Joint free electrical wire should use at work site (Connectors & Two pin are mandatory). 3. All electrical Switches lights should be placed in the proper place 4. Installation of temporary motor.

	I hereby declared that read through all the above safety instructions and committed to adhere to ensure Zero Incident/Accident

Extended WorkPermit

Any Changes in nature of Work / Location (Please Specify):

Excepted Duration of Work:

Start Date:^*

End Date:^*

Requested Time for Work:^*

Existing Documents dates Expired:

Raise WorkPermit

Permit Requester^*

WorkPermit Type^*

Details of Description of Work:^*

Exact Location of Work:^*

Date of Submission:^*

Time

Expected Duration of Work

Start Date:^*

End Date:^*

Requested Time for Work:^*

(Note: Preferably all work shall be Mall Non-Operational Hours only)

Dept./Brand/Contractor Details

Organization/Department:^*

Brand/Shop Name:^*

Name of Contact Person^*

Mobile No^*

Emergency Contact^*

ID No/SSN No/PAN Card No^*

Address^*

Contractor Detail (Who do the execution of work)

Company Name:^*

No. of Workers:^*

Contact Person Name:^*

Contact Number:^*

Workers Name List:^*

Documents to be Enclosed

Plan /Drawing Submission

Workman Compensation

Retailer Indemnity

Contractor Indemnity

Hazard Identification and Risk Assessment(General) and Safety Plan/Instructions (To be evaluated by an expert of Job initialiting/Executing Department) (Mark off the considerable factors in each title)

Risk Identified

Body Injury/Scratch

Collision with vehicle

Tripping/Sliding/Fall of man/material

Accidental fall of human

Damage to buriod cables

Fire/Burns

Electrical Shock

Explossion

Suffocation

Poisoning

Impact to other installations

Dust emission

Engineering Control

Useges of approiate and fully serviceable equipement/tools

Regular Maintenance and periods cheeks of equipement

Suitable Communication Device

Administrative Control

Work carried out/supervised by competent and authorized person

Strict adherence to SOP

Dont't walk in unauthorized area

Safety briefing (tool box talk)

Proper maintaince of equipement

maintenance record

Reliable equipement's

Antiskid arrangements

Trained man power

Staff understand their duties and responsibility

Availability of suitable fire appliances

Barrieading/Safety warning

Shutter,Safety warning

Emergency awareness procedures

Comply to real time work instruction

Essential phone No.with work sup for emergency use

Fire Extinguishers

PPE

Helmets

Eye Protection

Ear Plugs

Safety Hamess

Bad wether lothings

High vis jacket

Appropriate Gloves

Safety shoes

Illumination

protective Clothing

Hand protection/Gloves

Face shield

Dust/Mouth Mask

Full Body Hamess

Note: An adequate Risk Assessment of the activity carried out for applying the neccessary mitigation measures to minimize the potential risk.The risk level for HIRA (general) is to be declared after considering the implementation of Engineering control,Administrative control and PPE for the identified risk. A seperate detailed 'Safety Assessment' should be prepared for any major change in facility/major work.I have read and understand all the aspect of Terminal Works Procedure and undertake to brief and ensure compliance by all concern(Job executing team/supervisors)to abide by the above mentioned safety requirement.

Risk Factor
Acceptable/Not Acceptable

HIRA Prepared By(Job Initiator and Job Executer)
Name:		Date:

HIRA Reviewed By(Safety Department)
Name:		Date:

BY THE RETAILER/AGENCY/COMPANY/VENDOR
Name:

The operations department will only allow the work to happen after authorization from the security department.
Retailers Relations		Ops Manger
Manager - Loss Prevention		Sr. Marketing Manager
Finance Manager		Finance Manager
Chief Engineer		Sr. Manager Operation
General Manager

General Do's and Don'ts
SAFETY PRECAUTIONS REQUIRED
1. Safety clearance form should be pasted on work site with labor list & indemnity. 2. Duplicate key of work site should be available at mall security (Applicable for board out work site) 3. The Contractor should start work only after the site is safe for work. 4. Physical fitness is must for all workers. 5. No cooking or sleeping, No Smoking, No Spitting, No washing, is allowed in the premises as anytime. 6. No usage of any kind of alcohol, cigarettes, pan, and tobacco permitted in work area 7. No smoking signage should be displayed at work site. 8. Labour to be aware of Basic Safety, First aid, Emergency exits and Emergency Contact numbers.
Access Movement
1. No work should happen in customer area between 10am to 11pm (MOD may permit). 2. No Labor movement in customer area during trading hours. 3. No disturbance should be caused to customer. 4. Identity card to be issued by Contractor & Site Card by Inorbit Malls (Vashi). 5. Emergency numbers should be visible on work site. 6. All workers should carry / Display carries ID cards. 7. Only Mentioned workers in security clearance are allowed to work. 8. Contractors have to submit labor list with their residential address & contact Numbers of relatives.
Mandatory safety Measures
1. Safety signage should be properly displayed at all work sites. 2. Emergency light required at work site (Applicable for board out work site). 3. Safety Helmets to be worn (Mandatory for any work at 10 ft Height & Above). 4. Safety Harness to be worn (Mandatory for any work at 10ft Height & Above). 5. All ladders used for the work to be in good condition.(only aluminum ladders). 6. Required footwear to be worn while performing work in the Mall.(to be decided by nature of work ). 7. Fire extinguishers should be available at all work sites (Minimum 5Kg, DCP-Type). 8. Emergency Medical Kits to be available all work site. 9. Work site should be kept combustibles free. Proper storage closets for combustible and hazardous material should be maintained. 10. Fire exit to be kept free from obstruction.
Civil safety measures
1. A 35-foot safe zone in all directions from the welding area must be maintained by covering all combustibles with non-combustible material or removing them. 2. If any work happens at a height of 20ft or above then a security guard to be deployed. 3. Any modification to the sprinkler to be notified to MOD in advance to isolate and depressurize the system. Proper cover of the sprinklers to be fixed to the sprinkler vials. 4. Adequate ventilation to be maintained at work site.
Electrical safety measures
1. Electrical equipments should be in proper working condition. 2. Joint free electrical wire should use at work site (Connectors & Two pin are mandatory). 3. All electrical Switches lights should be placed in the proper place 4. Installation of temporary motor.

I hereby declared that read through all the above safety instructions and committed to adhere to ensure Zero Incident/Accident

Notice

WorkPermit Check

	Company Name

	Name
	Email Id
	User ID / Mobile Number
	Address

	Location
	Pin Code