CONCRETE / CORE DRILLING PERMITISSUE DATE: 01/07/2016

GOVERNMENT PROPERTY NSW
CONCRETE /CORE DRILLING PERMIT

DATE:
WORK REQUIRED:
GPNSW/Tenant contact: / Phone:
Company performing work: / Phone:
Company contact on site: / Phone:
LOCATION: / (Dwg. No. and distance from fixed object, if possible):
Commencement of interruption: / Anticipated reinstatement of services:
Date: / Time: / Date: / Time:

The position of the following services have been checked by the Authorised Spervisor:

Electrical Cables
Security Cables
Telephone Cables
Gas Pipes
Comp Air, & Vacuum
Water Supply Pipes
Sewerage & Trade Waste Pipes
Storm Water Pipes
Other Building Services
Asbestos Register

SPECIAL CONDITIONS ......

BARRIERS HAVE BEEN PLACED AROUND THE DRILLING SITE AND AROUND THE LEVEL BELOW. PEOPLE WORKING IN THE AREA HAVE BEEN NOTIFIED AND ANY EQUIPMENT OR SERVICES LIKELY TO BE EFFECTED HAS BEEN RELOCATED OR PROTECTED AGAINST WATER, DUST AND FALLING OBJECTS.

ACCEPTANCE OF PERMIT: I have read the rules and procedures of this permit and understand the job requirements and the precautions to be taken.

Name: / Contractor / Signature:

I have checked the location where the work is to be carried out and I am satisfied that all reasonable safety precautions have been taken.

Name: / Consultant / Signature:

I have been informed of the work and am satisfied that all reasonable safety precautions have been taken.

Name: / GPNSW Officer / Signature:
DISTRIBUTION: / Facilities  / Guards  / CRMS Desk 

RULES OF PRACTICE & PERMIT PROCEDURE ARE ATTACHED

RULES OF PRACTICE

  1. Prior to the commencement of any drilling, the employee or Contractor responsible shall obtain all available information relating to the location of embedded services in the required areas.
  1. When drilling through a floor, wall or ceiling the precise position of the penetration is to be determined by the person doing the work so that damage to personnel, plant and equipment on the other side be avoided.
  1. Personnel are to be advised to keep clear of the area, and plant and equipment is to be relocated or shielded against damage from water, dust and falling objects.
  1. If services expected to be uncovered are not located or if services are uncovered which are not expected, then further drilling shall cease and the Permit Issuer notified.
  1. Barriers shall be placed around all penetrations and areas below penetrations together with suitable warning signs.
  1. Water used in drilling operations shall be controlled from flowing to undesirable areas.
  1. Where it is desired to maintain the fire rating of a particular wall, floor or ceiling after drilling, suitable materials shall be used for filling the gaps after services have been run through the opening.
  1. In the event of an accident, all work shall cease immediately, and the Contractor informed. In the event of serious personal injury, also phone (ext 31) immediately.
  2. In the event of any asbestos being discovered, all work is to cease immediately, and the Contractor informed.

DRILLING PERMIT - PROCEDURE

  1. A permit is required whenever drilling through a wall or floor anywhere on the site.
  1. It is the responsibility of the Contractor to obtain the Permit prior to the commencement of the work.
  1. Contractors shall be made aware of the need for a Permit and relevant Procedures and Practices by the Contract Administrator. The Contract Administrator shall ensure the Contractor has signed the "Site Induction" form and is aware of the need for a permit before work commencing.
  1. The Permit shall be issued no more than 24 hours prior to the commencement of the work.
  1. The original Permit shall be kept by the RBA Officer. A copy shall be issued to and kept by the person doing the work and returned to the Contractor after the job is completed.

Custodian: WHS Manager / Uncontrolled copy when printed / ©GPNSW
Approved by: Place Management / Version: 1.1
Number: SMS-02-FM- A1071543 / Page 1 of 2