Daily Work Permit Audit Record

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Activity / Checks Made

• Are copies of the permit displayed properly?

  Yes

  No

  N/A

• Has the permit been documented properly?

  Yes

  No

  N/A

• Are any accompanying documents e.g. procedures / JSAs in place for this work?

  Yes

  No

  N/A

• Select YES if there are no issues with this permit or job. If there are issues with this permit or job select no and note in comments section.

  Yes

  No

  N/A

• Select YES if there have been NO new hazards observed on site. If new hazards have been observed select NO and note in comments section.

  Yes

  No

  N/A

• Is the required safety equipment in place?

  Yes

  No

  N/A

• Have the permit requirements been communicated to all users?

  Yes

  No

  N/A

• Does the actual work permit scope match?

  Yes

  No

  N/A

• Is appropriate supervision present on site?

  Yes

  No

  N/A