Information
-
Document No.
-
Audit Title
-
Location/Site
-
Conducted on
-
Employee Performing Audit
-
Location
-
Employee Completing Permit
-
Is the date correct on the permit?
-
Has the permit been issued more than 16 hours?
-
Is the Authorized Employee listed in the General Information section?
-
Is the description of work accurate and detailed?
-
Are special instructions completed correctly for the permit?
-
Is the venting/flaring question completed correctly?
-
Are appropriate selections made in the Safe Work section?
-
Are appropriate selections made in the PPE/Equipment section?
-
Are appropriate selections made in the Hot Work section?
-
Is Hot Work being performed?
-
Does the Hot Work include welding, cutting, grinding or an open flame? Is it Safe or At Risk?
-
Is the Atmospheric Testing section filled out appropriately?
-
Is Atmospheric Testing required to complete this job?
-
Is the Atmospheric Testing log properly completed?
-
Are emergency phone numbers listed on the permit?
-
Is there a Confined Space being entered on this job? Is it Safe or At Risk?
-
Is Energy Control required for this job?
-
Is the Energy Control log completed or an Energy Control Procedure attached to the permit?
-
Are appropriate selections made in the Energy Control Selection?
-
Was a Pre-Job meeting conducted?
-
Is a Safety Lead identified on the permit?
-
Are all employees and contractors listed in the personnel accountability section?
-
Has the Authorized Employee signed and dated the permit?
-
Is the Daily Excavation Checklist completed for this job?
-
Additional Comments:
-
Additional Job Photos
-
( Photo of Permit)