Title Page

  • Aviation Department Work Permit Inspection/Audit

  • Client / Site

  • Conducted on

  • Prepared by

Audit Information

  • Permit Type

  • Work Permit No.

  • Issuer Org:

  • Issue No:

  • Receiver Org:

  • Receiver No:

  • Work Location:

  • Duration:

  • Description of Work:

  • Permit inspection competed by:

  • Permit inspection reviewed by:

Permit Review

  • Correct type of permit issued?

  • Has a permit been issued?

  • Unofficial ticket being used instead of a PTW?

  • Issuer's certification current?

  • Joint site inspection conducted?

  • Permit properly counter signed?

  • Proper gas tests recorded?

  • Gas test equipment operational?

  • Permit properly closed? Extended?

  • Till when?

Field Review

  • Permit available at site

  • Receiver available at site?

  • Receiver certificate current?

  • Work scope defined properly?

  • Equipment properly identified?

  • Hazards properly identified?

  • Precautions properly defined?

  • Gas test properly conducted?

  • Receiver following permit instructions?

  • Barricade warning signs adequate?

  • Personal protective equipment (PPE) adequate?

  • Issuer's lockout/hold tag adequate?

  • Receiver's lockout/hold tag adequate?

  • Standby-man available?

  • Tools in acceptable condition?

  • Scaffold acceptable and tagged?

  • Acceptable excavation procedure?

  • Equipment isolated/depressurized?

  • Equipment clean/purged?

  • Current crane inspection sticker?

  • Current heavy equipment operator's license?

  • Housekeeping/storage acceptable?

  • Health hazards addressed?

Fire Protection 🔥

  • Fire protection equipment available and adequate?

  • Fire watch available and qualified?

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