Ref. No:21-0316A
ISOLATION REQUEST &PERMIT TO WORK
1.
ISOLATION REQUEST-TO CE(O)/ CE(Col. (North,East,West,South)COLOMBO CITY
I hereby declare that the High Tension Maintenance unit requests the release of plant/apparatus from service for the
below mentioned purpose.
(i)
LOCATION: Sub 655, No. 30, Galpotta Street Colombo 13
(ii)
PLANT/APARATUS TO BE RELEASED: RMU, TF & LTP
(iii)
PURPOSE OF RELEASE:For Seasonal Maintenance (Cancelled previous week)
(iv)
DATE & TIME OF RELASE: DAY:Friday DATE:2021.03.19
TIME:08.30am
SIGNED
to
0430pm
(Engineer Requesting Release)
Contact No. 0710 183 816 (EE- HTM)
Date: 2021.03.16
Mr. Rasanjana (HTM-S)Mr. Gomas(HTM-W) Mr. Ukas (HTM-E)Mr. L.M.D Lakmal (HTM-N)
Tel. 0718506990
Tel. 0714908910
Tel. 0714291080
Tel. 0714150766
2.
ISOLATION - AUTHORIZATION / ACCEPTANCE
1.1 AUTHORIZATION – TO CE (O)/Area Engineer:Please release the above plant/apparatus with suitable
alternative supply arrangements to other plant/ apparatus.
SINGED ………………………...............CE (O)/Area EngineerDate: ……………………
1.2 ACCEPTANCE – TO ES (HT Operation / LT Breakdown)
I hereby declare that the above mentioned apparatus can be released from service on the date and at the time as
stated above. Please isolate plant/apparatus indicated above& make earth connections. Contact Engineer
(Operations) in CCCC to get the Work Permit Reference No. and activate the work permit.
SINGED ………………………................ …….. Electrical Engineer
Date: ………………
___________________________________________________________________________________________
3. PERMIT TO WORK ISSUE
PTW Ref: No. ………….. ……….Date ……….….
(i)
To ……………………………………. (Person in charge of work).
I hereby certify that the following Plant/Apparatus is safe to work on being dead, isolated and where practicable
locked off from live conductors and earthed in accordance with C.E.B. Safety Rules.
(ii)
PLANT/APPARATUSIDENTIFICATION ………………………………………………………….
……………………………………………………………………………………………….
(iii)
POINTS OF ISOLATION ……………………………………………………………………….
………………………………………………………………………………………………………….
(iv)
CIRCUIT MAIN EARTHS APPLIED AT ………………………………………………………….
………………………………………………………………………………………………………………..…..
Additional earths may be applied at point of work
ALL OTHER PLANT/APPARATUS IS DANGEROUS
(v)
(vi)
WORK TO BE DONE
……………………………………………………………………………………………
REMARKS/KEY SAFE KEYS ISSUED (WHERE APPLICABLE)
……………………………………………………………………………………………………………………
(vii)
Issued with Consent of …………………………………………… Operations Eng/Control Person
(viii)
PERMIT ISSUED BY ………………………SIGNED
Time ………………… Date ……………
(Being an authorized person with authority to issue permits)
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