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)

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