Magicsoft Asia night PROJECT : Confirmed WORK AT HEIGHT ON A SCAFFOLD (>2M) PERMIT Permit No. : AAG-PTW-WH_SC-18-00008 Part 1: Application Validity Period (Date & Time of work) : From: 10/08/2018 (Date) 19:00 (Time) To: 11/08/2018 (Date) 07:00 (Time) Contractor : Magicsoft Asia Description of work : test Daily Check By Work Supervisor-In-Charge and/or Safety Assessor (Yes, No, “NA“ for Not Applicable) Minimum Safety Requirements Approved Risk Assessments available Yes Safe Work Procedures available Yes Job Specific Fall Prevention Plan available Yes PTW/ Location Plan displayed at place of work Yes Workers are briefed on the hazards & corresponding control measures Yes Workers are medically fit to work/ not feeling unwell/ not overworked Yes Workers are reminded to do Last Minute Risk Assessment (LMRA) before start work Yes Adequate safe means of access/ egress provided. Yes Adequate lighting provided at workplaces & along access/ egress Yes Safety harness with double lanyard & shock absorber provided/ used as fall arrest-eqpt or Safety belt provided & used as fall-restrain eqpt Yes Monthly Inspection & colour coding of PPE implemented Yes Adequate edge protection provided - top rail/ mid rail/ toe board (Top rail 1m high / mid rail < 0.6m high / toe board 90mm high) Yes Safe work platform - min. 500mm width/ secured Yes Comply with Safe Working Load; no overloading of platform Yes Valid 'Safe to use' tag displayed (after inspection, at least once a week or after increment weather) Yes Barricades and signages provided below; area clear of incompatible works around work area Yes Good housekeeping maintained - no storage of unused materials/ debris on platform Yes MOM Approved Scaffold Contractor/ Team (Scaffold >4m high) Appointed Yes PE certificate of supervision available for lifeline Yes Lifeline & anchorage points are provided/ constructed/ inspected as per PE Design Yes Others : Part 2: Check & Endorsement a) I have read & understood this permit & agree to work in accordance with the provisions of the RA/ SWP/ Method Statement & the safety requirements stated in this permit. b) I have checked the site & satisfied that reasonably practicable steps will or have been taken to safeguard the safety & health of the persons working & in the vicinity a. Applicant/ Work Supervisor (Work at Height Supervisor) Name Applicant Signature Time 12:03 b. Safety Assessor (Shimizu) (WSHO/ WAH Assessor) Name Safety Assessor Signature Time 12:24 c. Shimizu Engineer/ Supervisor In-Charge (Work at Height Supervisor) Name Engineer Signature Time 12:25 Part 3: Issued By a) I am satisfied that proper evaluation of risk & hazards involved based on available information b) I am satisfied that no incompatible works will be carried out e.g no concurrent activities @ same elevation, etc c) I am satisfied that all reasonably practicable measures will or have been implemented & enforced d) The working personnel are informed of the hazards & protection counter measures to be taken Site Overall In-Charge (SC PM / WAH Manager/ Manger with CSCPM Certificate) Name PM Signature Time 12:25 Part 4: Notice of Revocation or Closure a) Work has been terminated/ completed b) Housekeeping has been carried out c) Work area is safe for other personnel Applicant/ Work Supervisor (Work at Height Supervisor) Name Applicant Signature Time 12:26 Part 5: Confirmation of Revocation or Closure a) Work has been terminated/ completed b) Housekeeping has been carried out c) Work area is safe for other personnel Site Overall In-Charge (SC PM / WAH Manager/ Manger with CSCPM Certificate) Name PM Signature Time 12:26