Title Page
-
Site conducted
-
Conducted on - Day / Time
-
Checked by
-
Contractor Company Name
General
-
Permit - Access only?
-
Permit - To carry out works?
-
Are the names and dates correct on the permit?
-
Is the permit signed to confirm the "house rules & regulations" have been raised and understood?
-
Is the area the contractors are working in clean and tidy with no trip hazards ? And no eating, drinking or smoking taking place?
-
Are correct signs or barriers required and in place?
Lone Worker
-
Are procedures in place for the lone worker as Per House Rules and Regulations with signed Lone worker form in place? (e.g regular contact/communication with the Control Team / radio)
-
Are the contractors working as per any special instructions on the permit?
-
Are works being carried out safely (e.g no drilling, hammering near moving vehicles or pedestrians)
Hot Works (if requested on Permit)
-
Are Fire alarm isolations authorised and in place?
-
Is area cleared of combustibles (paper, wood, rubbish. etc.)
-
Is additional fire protection in place ?(Fire Extinguishers/Blankets/sprinkler systems)
-
Is a Fire Watch in place ( person named on permit) are they on site ?
Electrical Works (if requested on Permit)
-
If scaffold, ladders or MEWP are required are they being used safely and correctly
-
Are the contractors using the correct PPE? (e.g harnesses, lanyards identified on the permit)
Confined Spaces (if requested on Permit)
-
Are the contractors working as per works identified on the permit?
