Niblock Site Management-Working at Height Permit

• Conducted on

  Date

• Prepared by

Guidance: Site Management must this Permit to Work when carrying out Working at Height activities. A copy of this document should be used as a working document and kept on site for the duration of the project in the site safety file file. Support documentation is contained in Part two of the Policy for further guidance.

• Project Name:

Duty Holder’s Safety Checklist:

• Has this specific work been planned and organised by competent persons?

• Has a Risk Assessment been carried out specifically for this task?

• Has a Method Statement been produced specifically for the task?

• Have all persons required to work at height received a safety induction and been informed of the details of the Risk Assessment and Method Statement particular to this work?

• Have lessons who are required to work at height received safety and competency training for this type of work?

• Are persons who are required to work at height suitably competent and fit?

• Has work at height been minimised wherever possible?

• Is access equipment for working at height suitable and safe?

• Had access equipment for working at height been inspected by a competent person?

• Are others in the vicinity who could be affected by this particular work at height safeguarded?

• Are weather conditions suitable to allow this work to be carried out?

• If a crane is to be used, is a Lifting Plan in place?

• Are there emergency rescue procedures in place?

• Other specific control measures and conditions