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LOTO Permit

The document outlines the Lockout-Tagout (LOTO) permit process for a joint venture project between Kolin Insaat and Saudi Structures, focusing on safety procedures for isolating systems before work begins. It includes inspection items to ensure safety compliance, as well as sections for recording lock pad data and signatures from permit holders and issuers. The document emphasizes the importance of proper training and adherence to safety protocols during the work activities.

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78 views2 pages

LOTO Permit

The document outlines the Lockout-Tagout (LOTO) permit process for a joint venture project between Kolin Insaat and Saudi Structures, focusing on safety procedures for isolating systems before work begins. It includes inspection items to ensure safety compliance, as well as sections for recording lock pad data and signatures from permit holders and issuers. The document emphasizes the importance of proper training and adherence to safety protocols during the work activities.

Uploaded by

Subzone Three
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Kolin Insaat Turizm Sanayi ve Ticaret A.S.

& Saudi Structures Contracting


Company Joint Venture
Package 1 - Roads and Utilities: Lake Perimeter and Relax, and Wet & Dry
Utilities - Contract #: 4800001162

LOTO Permit
General Data
Area/Zone : Date of Permit :
Supervisor name : Contractor :
Related Permit : No. of related permit :
Description of work

Inspection Items
S. Item Yes No N/A
N
1 Is the system switched off before starting the work?
2 Is the residual energy discharged?
3 Are the lines tested to be sure that there is no any residual energy?
4 Is the isolation of the lines being safe and will not affect other system negatively?
5 Is the right and suitable PPE provided and being used?
6 Is the permit holder competent enough?
7 Is all included in the work activities well trained for the job?
Lock Pads data for locks which will be removed or fixed
S.N Lock Pad No. Type of isolated item Time to fix Time will be Extension Signature of LOTO Mob. No.
the lock removed time issuer (in case Coordinator
of extension)
Switch
Door
Valve
Switch
Door
Valve
TASK SUPERVISOR /FOREMAN (PERMIT HOLDER)
All safety Procedure related to work is well understood in addition to the LOTO system for isolating the system before starting the work,
accordingly , the safety precautions which is mentioned in the below will be follow

Permit holder : Mobile Number :

Permit issuer
Kolin Insaat Turizm Sanayi ve Ticaret A.S. & Saudi Structures Contracting
Company Joint Venture
Package 1 - Roads and Utilities: Lake Perimeter and Relax, and Wet & Dry
Utilities - Contract #: 4800001162

All isolation are implemented, and the system no isolated, in addition to that all safety precaution is in place

Permit issuer : Mobile Number :

Permit Cancellation

S.N Lock No. Signature Time of signature

Permit Receiver : Mobile Number :

Permit Issuer : Mobile Number :

Notes

 The removing and fixing the lock pad must be by the person who issued work permit.
 If the mechanical or electrical system is complicated, then the detailed description for the area
which will isolated must be stated and well described.

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