Ryobi Kiso (S) Pte Ltd

EXCAVATION PERMIT
Permit no.: Attach Permit No: This permit is valid for 7 days from the time of approval. Application must be submitted at least 3 day in advance. Work on Saturday Sunday and !onday must be applied by Friday. Sketch to be attached Part 1: Application To Be Completed By Sub-Contractor
Work Performed by : Name of Supervisor in $har&e: 'ocation: (ate ) Time of *ot Work: +rom : To: No. of Wk "name of Sub#$ontractor%

,*S -e.uirements Prior Application of /eneral Work permit by Permit Applicant S 0 1 3 2 3 5tems Excavator is approved to be used Barricade, warning signage, hazard ights provided Su!!icient ighting !or night wor"s Ade.uate ventilation Status Si&n
Sta .

0
Si&n

Inspection By EHS Personnel durin course o! "or# 1 3 2 3 4

Sta. Si&n St a. Si&n St a. Si&n St a. Si&n St a. Si&n St a.

7
Si&n

Provision o! ade#uate shoring $ bracing %ateria s 4 Provision o! ade#uate adders !or access 7 PE design !or excavation depth & '% deep or unsupported excavation & ()*% 6 Location o! underground services predeter%ined $ protected + supported -yobi 7iso Sup8,n&r8*9( W5S $omply (escription of Work:

Part $: C%ec# & Endorse By 'yobi (iso EHS )epartment

Work area is safe -easonably practicable steps have been taken to safe&uard the safety and health of the :orkin& personnel (ate8Time:

Name8Si&nature: Part *: Endorse By 'yobi (iso Super+isor,En ineer

A:are of the :ork to be done and ensure that all safe :ork procedures to be complied :ith. (ate8Time:

Name8Si&nature: Part -: Appro+al By 'yobi (iso Head o! )epartment

5;m satisfied that all reasonably practicable measures have been implemented and enforce and the :orkin& personnel are informed of the ha<ards and protection counter measures to be taken. The above mentioned :ork is: Approved 8 Not Approved Name8Si&nature: (ate8Time: Part .: /oti!ication 0! Completion 0! 1or# By Sub-Contractor

Work has completed.

Name8Si&nature:

*ousekeepin& has been carried Work area is safe for other personnel. out. (ate8Time:

Part 2: Con!irmation By 'yobi (iso Super+isor,En ineer

Work has completed.

Name8Si&nature:

*ousekeepin& has been carried Work area is safe for other personnel. out. (ate8Time:

Note: 0. 9ri&inal $opy = to be displayed at hot :ork location 1. 5f permit is to be reapplied for :ork not completed :ithin 7 days part 3 ) 4 does not apply.

Legends, > - .K+/ood 0 - 1ot .K+Bad 12 - 1ot 2pp icab e

EOHSMS-02-F03_Rev 0

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Issued on 15 Sept 2010