11. Breaker racked in to service position
12. Control supply switched on
13. Space heater supply switched on
14. Breaker / MCC Module front door closed
15. MCC [MCC Module] switched on
Date : Name :
Time : Designation : (Signature)
ANNEXURE-4
PART-I
Sr. No.:
ELECTRICAL ISOLATION / ENERGISATION PERMIT - HT
De-Energise Clearance Certificate For HT Equipment
[To be filled by Operation-In-Charge of working area]
Unit Equipment
Tag No.
Date Equipment not in operation
Requirement: Emergency
Ordinary
LOTO operation performed on “Local Switch”
Kindly de-energise the above equipment.
Date : Name :
Time: Designation: (Signature)
JOB COMPLETION CERTIFICATE
[To be filled by Authorised Person of Electrical Operation]
The equipment is de-energised after performing following Checks /
Activities:
Isolation device is in SS No. and it’s ID
YES NO N/A