Permit Details
Permit Number AL Ez/B/12.8/2025/1114
1. Application And Description
Location : Burhan Field
Work Site : BURHAN NORTH FIELD-FAWZ-B TO OP-7 GRADED ROAD
Work Description : TO CARRY OUT THE ACTIVITIES FOR GRADED ROAD REPAIRING
AND ROAD EXTENTION WORK, BACKFILLING GRADING, LEVELLING, CUTTING,
WATERING AND COMPACTION, EXCAVATION FOR BORROW PIT, UNDULATED AREA
CUTTING, DIESEL FILLING, EQUIPMENT LOADING AND UNLOADING, MATERIAL
LOADING AND UNLOADING SOIL AND BY USING DOZER, WATER TANKER, TIPPER,
SHOWEL, GRADER, ROLLER, EXCAVATOR, CRANE, DIESEL TANKER, LOW BED
TRAILER, MINIBUS, 10T HIAB, 3TON, ITON PICK UP, POWER AND HAND TOOLS.
Activity Nos. ( Refer to 1.9 ARA-HSSE-PR PTW, Section 3.3)
Process Facility Hydrocarbon Area Non Hazardous Area
Associated Permit Nos. :
Planner Agrees In Frozen Plan : YES
Work Order / EWP No :
Hazardous Area Classification :
HAZARDOUS ZONE 1
HAZARDOUS ZONE 2
NON - HAZARDOUS
NORM Contaminated Area : NO
Mercury Potential : NO
H2S Facility Classification : High Low Normal
Expected Max PPM : 0
Vehicle Entry Required? NO
2. Certificates Attached To This Permit
Certificate Name Download Certificate
TRIC Download
Risk Assessment Download
Excavation Download
Other Download
3. Gas Testing Requirements
Gases to be tested for :
Hydrocarbon H2S Oxygen Other (Specify) : HYDROCARBON, H2S, OXYGEN, OTHER
Gas test to be repeated at intervals of : 0 Hours.
Continuous gas monitoring required during execution of the work : NO
3a. Worksite Examination Required By Area Authority
WORKSITE EXAMINATION 1st day : NO
By Validator required Everyday : NO
4. Application By Applicant
I have reviewed the task and am satisfied that the information in this Application and in the Job HSE Plan
is adequate and correct
Name : Al Ez - Muhammad ziafat
Position :
Contractor : Al Ez - HSE
Tel. No. : 90983055
Date : 28-08-2025 08:06 PM
Duration Requested FROM Date : 30-08-2025 12:00 AM TO Date : 20-09-2025 12:00 AM
5. Agreement By Other Affected Custodian
I agree that the work described may be carried out during the proposed period :
6. Authorisation By Responsible Supervisor
I have examined the Permit and Job Safety Plan. The work described in this Permit and attached Job
safety Plan is authorized for this period :
Daily Pre-Validation Allowed? NO
24 Hour Validation Allowed? NO
FROM Date : 30-08-2025 12:00 AM TO Date : 20-09-2025 12:00 AM
Name : Mohammed Al Hashmi
Designation : TEAM LEAD - CONSTRUCTION
Approval Status : Approved
Remark :
Date : 29-08-2025 04:39 PM
6a. Production Coordinator/Supervisor
Name : Faisal Al Mandhari
Designation : SUPERVISOR- CONSTRUCTION
Approval Status : Approved
Remark :
Date : 30-08-2025 05:43 AM
6b. Examination Authorisation By Responsible Supervisor
Extension valid until : Date :
Name :
Approval Status :
Remark :
Date :
7. Vehicle Access To Restricted Area
Permission is given to the Permit Holder to take the following vehicle(s) of the following type(s) to the work
site/location : Vehicle Access Route Plan prepared and approved : YES
https://araprodstorage.blob.core.windows.net/fileattachment/SiteImages/No_CheckBox.png
Vehicle Types : Location :
Permit No : AL Ez/B/12.8/2025/1114
Vehicle Access is subject to a satisfactory gas test being carried out on each occasion, with the result
recorded in Box 8.
8.Gas Test Record - Results For Confined Space Entry To Be Recorded On Certificate, Not Here.
Date Result User
9. Safety Coordination (Field HSE)
Any conflicting work identified will be Suspended or Cancelled before first Validation. Worksite
preparations specified in Box 2 may proceed.
Name Date
10. Tric Talk
Sr. No. Date TBT Leader Attendee Name Position
1 30-08-2025 06:09:36 AM Usman Arshad Bajwa Izat ali Banksman
2 30-08-2025 03:29:18 PM Usman Arshad Bajwa Ibrar HDD
3 31-08-2025 04:40:15 AM Usman Arshad Bajwa Imran Operator
4 31-08-2025 02:52:54 PM Usman Arshad Bajwa Imran Operator
5 01-09-2025 04:31:16 AM Usman Arshad Bajwa Ibrar HDD
6 01-09-2025 02:44:49 PM Usman Arshad Bajwa Imran Operator
7 02-09-2025 04:28:33 AM Usman Arshad Bajwa Imran Operator
10 a. Validation
To be signed by the Area Authority at the start of each work period. I am satisfied that the conditions
at the worksite are safe for the work specified. I validate the Permit for the period stated, provided the
work party adhere to the permit requirements. Work must stop if the permit requirements cannot be
met.
Name Date From Date To
Faisal Al Mandhari 30-08-2025 06:11 AM 30-08-2025 12:30 PM
Faisal Al Mandhari 30-08-2025 03:34 PM 30-08-2025 06:00 PM
Faisal Al Mandhari 31-08-2025 05:16 AM 31-08-2025 12:30 PM
Faisal Al Mandhari 31-08-2025 03:30 PM 31-08-2025 06:00 PM
Faisal Al Mandhari 01-09-2025 05:17 AM 01-09-2025 12:30 PM
Faisal Al Mandhari 01-09-2025 03:08 PM 01-09-2025 06:08 PM
Faisal Al Mandhari 02-09-2025 05:12 AM 02-09-2025 12:30 PM
10 b. Acceptance
To be signed by the oncoming Permit Holder whenever the permit is validated or whenever
responsibility passes from one Permit Holder to another. I have been fully briefed by the Applicant on
the work and necessary precautions. I am satisfied that the worksite is safe for work to start. I will brief
the work party and supervise the work. I will stop the work if the permit requirements cannot be met.
Name Designation Date
Usman Arshad Bajwa Civil 30-08-2025 06:13 AM
Usman Arshad Bajwa Civil 30-08-2025 03:35 PM
Usman Arshad Bajwa Civil 31-08-2025 05:24 AM
Usman Arshad Bajwa Civil 31-08-2025 03:23 PM
Usman Arshad Bajwa Civil 01-09-2025 05:28 AM
Usman Arshad Bajwa Civil 01-09-2025 03:14 PM
Usman Arshad Bajwa Civil 02-09-2025 05:15 AM
10 c. Suspension
To be signed by the offgoing Permit Holder whenever work stops for more than 4 hours. I have
examined the worksite. It has been left in a clear and safe condition.
Name Date
Usman Arshad Bajwa 30-08-2025 12:31 PM
Usman Arshad Bajwa 30-08-2025 05:54 PM
Usman Arshad Bajwa 31-08-2025 12:44 PM
Usman Arshad Bajwa 31-08-2025 05:48 PM
Usman Arshad Bajwa 01-09-2025 12:25 PM
Usman Arshad Bajwa 01-09-2025 05:54 PM
11. Permit Cancellation Status : No Action
a. Permit Return by Permit Holder
No Action
Name :
Designation :
Date :
b. Permit Cancellation by Area Authority
Worksite and equipment affected left in a safe condition :
Worksite checked, clear and safe (Process Facility only) :
Reinstatements/De-Isolations Complete :
Name :
Designation :
Date :
