Information
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Conducted on
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Location
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Inspected by:
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Inspected by:
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Inspected by:
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Inspected by:
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Has the correct permit been selected for the task e.g. Hot work, Excavation, Confined space.
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Permit Numbers:
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Permit within validity period
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Valid From
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Expiry Date
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Permit and TRA available at work location within the vicinity of the work group.
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Where is it located
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Is the Permit requirements understood by relevant personnel.
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Are personnel complying with Permit / Procedure requirements?
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Comment
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Are isolations in place and verified
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Positive verification of zero energy
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Comment/Observation
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Is TRA current and specific to task being performed and addresses the Permit requirements?
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Date of TRA revion
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Are personal danger tags correctly filled out and in place
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Are Permit close out requirements being complied with?
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Comment/Observation
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Has the Permit been altered?
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Comment/Observation
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Is the permit holder available at the workplace?
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Permit Holder
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Are all persons working under the permit signed onto the TRA?
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Required action:
