Classification: Public Rev. 00 June 2018 Page 1 of 25

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22 Appendix 1 SAFE WORK PERMIT FOR SHIP REPAIR JOBS / PORT JEBEL ALI/ PORT RASHID/ PORT HAMRIYAH/ DUBAI MARITIME CITY/OTHER PCFC-TRAKHEES JURISDICTION Permit No: COLD WORK HOT WORK CONFINED SPACE ENTRY (Tick Applicable Box) 1. General Details Ship Name Ship Type Port/Ship Yard Name Ship Flag Berth/Yard Number Ship Repair Company or Ship Operating Company Validity From To Date Date Location of Work Description of the Job Hours IMO Hours Safety Officer Responsible for the Work Area Name Signature 2. Safety Control Measures Area of Control Item YES NO NA General Safety / Tool Box Talk Conducted/Risk Assessment Prepared Emergency Procedure Defined and Understood by All Workers Display Of Appropriate Signboards At The Work Area Hot Work Work Area/Equipment Inspected and Made Safe. Surrounding Area Checked, Cleaned Up, Oil/ Rags/ Combustible Material Removed and Made Safe. Adjacent Drains/Vents, Manholes Covered and made Safe / All Deck openings barricaded Charged Fire Hose/Portable Fire Extinguisher Provided. Shield Against Sparks Provided and Ignition Hazards Contained. Non-Combustible Fire Blanket Provided to Contain Sparks. Adequate PPE as per Requirements Made Available Supply of Sufficient Forced Ventilation, Provision of Adequate Lighting and Welding Fumes Exhaust Hot Work Minimum 500 mm from Fuel Tank/Vent Equipment/Tank/Adjacent Tanks Gas Freed / Inerted/ Water Filled And Made Safe. Fire Watch Name: Signature: No Hot Work Within A Radius Of 3 Meters Dismantling / Use Of Containers For Collecting Oily Water / Oil Testing of Pipes & Valves No Incompatible Work Processes Being Carried Out In The Same Vicinity At The Same Time Equipment/Pipeline Is Free Of Liquids/Water Flushed/Purged /Isolated. Work Area Has Been Gas Freed And Made Human Worthy, Gas/ Oxygen Frequent Monitoring With Audio Visual Alarm Is Made Available. All Deck Openings Barricaded Confined Space Entry Suitable Continuous Ventilation And Illumination Provided. Tags Provided For Head Count And Notices. Suitable Communication System Provided/Tested Means of Evacuation/Rescue Equipment Available At Site Man In Attendance Name: Signature: Full Body Harness Worn By Workers Scaffolding Is Solid Secured Tags Provided And Signature Verified Working At Height Handrails Provided And Planks Secured Proper Access Provided And Ladders Secured Supply Of Sufficient Forced Ventilation No Hot Work In The Space To Be Painted /Cleaned Adequate Flame Proof Light In Good Condition Provided Rev. 00 June 2018 Page 22 of 25

23 Special Conditions/Precautions/Attachment Use Of Cartridge Type Respirator/ Air Fed Mask Chemical Resistant PPE Provided For Workers 3. Authorization Signatures Issuing Authority Performing Authority Ship Repair Surveyor I certify that I have inspected the location of work and it is safe to start the hot work/ cold work /confined space entry. I have inspected the job site, accepted all required precautions and continuous job site supervision needed for safe work. I have verified all work permit conditions including gas measurement and it is approved and safe to commence the job. Name: Signature: Name: Signature: Name: Signature: Date: Time: Date: Time: Date: Time: Trakhees ID No Trakhees ID No Trakhees ID No 4. Permit Closure Signatures Performing Authority Issuing Authority Job is stopped/ completed and men, material & machinery are withdrawn, job site is cleaned and permit may be cancelled. The Job is completed, location of work inspected and considered safe. Work permit is hereby cancelled. Name: Signature Name: Signature: Date: Time: Date: Time: Trakhees ID No. Remarks ( By Competent Authority Only ): Trakhees ID No. Permit No : 5. Gas Free Permit Sketch the Location of Tanks/Spaces Gas Tested GAS Testing Reading Shall be Performed Prior To, And During Hot Work / Confined Space Entry ( CO, H2S readings given in ppm / O2 reading given in % Vol / Combustible Gas reading given in % LEL) O2 CO LE H2S Tank Name O2 CO LEL H2S Tank Name L Daily Endorsement Surveyor Name Trakhees ID Date /Time Signature Day 6. Gas Free Permit Revalidation Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 7. Safe Work Permit Revalidation Validity Period Performing Authority Issuing From To Authority Night Day shift shift 1 Date Time Date Time 2 Date Time Date Time Safety Officer Fire Watc h No of Peopl e Rev. 00 June 2018 Page 23 of 25

24 3 Date Time Date Time 4 Date Time Date Time 5 Date Time Date Time 6 Date Time Date Time 7 Date Time Date Time RULES FOR ISSUANCE OF SAFE WORK PERMIT 1. Issuing Authority - Trakhees EHS Approved Project Manager/Project Engineer/Safety Officer of the Business Unit or Master of the Ship is the Permit Issuer and Responsible for Entire Work and Coordination. 2. Performing Authority -Trakhees EHS Approved Ship Repair Company Supervisor or the Responsible Ship Officer. 3. Competent Authority - Trakhees EHS Officer. 4. Ship Repair Surveyor - Trakhees EHS Approved Ship Repair Surveyor. 5. Safe Work and Gas Free Permit Maximum Validity 24 Hours. 6. EHS Approved Third Party Agencies Supervisors & Surveyors Only Shall Mentions their Trakhees-ID Number in the Permit. 7. Ship Repair Permit is Mandatory for All Types of Non-Routine Jobs as per Defined in EHS Regulations and Guidelines. 8. All Permits Shall be Re- Issued in case the Vessel Changes its Location. 10. All Relevant Conditions in the Permit Shall be Checked and Ticked as Appropriate. 11. Permit Copy Shall be Available at the Work Site for Competent Authority Verification. 12. No Signatory Shall Sign for Both Issuing Authority and Performing Authority. 13. Upon Completion of the Job(s) the Permit Shall be Closed by Issuing Authority & Performing Authority by Signing at the Relevant Columns. 14. Trakhees-EHS Approved Ship Repair Surveyor Shall Approve all Hot Works and, Vessel Enclosed/ Confined Space Entries. 15. All Concerned Personnel(s) Involved in the Issuance of the Safe Work Permit for Ship Repair Jobs are Required to Fully Understand and Comply with the Applicable Provisions of EHS Rules & Regulations for Shipyard and Associated Industries, for the Safe Conduct of the Planned Repair Work. 16. Any Emergency Situation makes this Permit Invalid and New Permit Shall be Issued for the Job to be Re-Commenced. 17. In case of any emergency, immediately contact Command Control Centre (CCC) : (Ports Areas) ; Dubai Maritime Security (DMC Areas) : Distribution of the Permit Copies Immediately After Approval by Trakhees-EHS Ship Repair Surveyor: Original (White): Work Site/ Location of Work First Copy (Pink): EHS Ship Repair Surveyor Second Copy (Blue): Marine Department 19. Surveyor Shall Fill the Tracking Sheet and Upon Completion Shall Submit by to EHS Ports Department (ehs.ports@trk.pcfc.ae) RULES FOR SAFE WORK PERMIT REVALIDATION 1. Safe Work/Gas Free Permit Revalidation Table Must be Renewed Daily Even If Permitted Work Is Not Carried Out. 2. In case of No Work, Performing Authority is Only Exempted from Signing. 3. In case of Shifts System Revalidation Sheet will be Signed Prior Each Shift. 4. If Safe Work / Gas Free Permit is Not Revalidated on Daily Basis; The Safe Work Permit Must be Cancelled. 5. Safe Work / Gas Free Permit Can Be Extended To A Maximum Duration of 7 Days from the Date of Permits Issuance. 6. Revalidation Table Shall be Signed Only by Authorized Signatories. All rights reserved. No part of this PMF-01e: Safe Work Permit for Ship Repair Jobs, may, for sales or issuing purpose, be produced, stored in a retrieval system or transmitted in any form or by any means, electronic, electrostatic, magnetic tape, mechanical, photocopying or otherwise, without prior permission in writing from the Trakhees- Environment, Health and Safety Department Rev. 00 June 2018 Page 24 of 25

25 Permit No Date Issued Vessel Name Location Permit No Date Issued Vessel Name Location Rev. 00 June 2018 Page 25 of 25