Permit Request

  • Work Activity Title (Description)

  • Specified high-risk work tasks covered to work by this permit

  • Start of Work

  • Duration of Permit

Service Drawings

  • Have Site inductions and RAMS been briefed and signed

  • Are on-site service drawings available and have operatives carrying out the works been briefed on existing services.

CAT & Gennie

  • Does at least one of the team hold a valid in date (3 years) CAT & Genny qualification?

  • CAT & Genny Serial Number

  • CAT & Genny Calibration Date

Trial Holes

  • For identified services, have trial holes been dug by hand to ascertain service depths?

  • Will hand digging with insulated tools be used when digging trial holes?

  • What services were found?

  • What depths where services located?

  • Have service routes been marked with paint/pins?

  • Are works deemed safe to proceed?

  • Full Name and Signature of Supervisor

Safe Trench/Excavation Practices

  • Are Trench boxes being used for these works exceeding 1.2m?

  • Will shallow excavations be stepped or battered back?

  • When digging around services, will insulated tools be used?

Plant & Equipment

  • Has all plant undergone a weekly inspection?

  • Are all operatives trained to operate plant?

Works briefed and Explained

  • Full Name and Signature of Supervisor

  • Full Name and Signature of Excavator Operator

  • Full Name and Signature of Other Operatives

  • Full Name and Signature of Other Operatives

  • Full Name and Signature of Other Operatives

Completion of Works Sign-off

  • Full Name and Signature of Supervisor

  • General Comments

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