Permit to Strike

• Contractor / Item to be struck

• Document No. GCL:

• Permit to strike:

• Conducted on

  Date

• Prepared by

• Location
  Address

Falsework/Temporary Works Design

• Name of original design engineer(s):

• Design drawing number(s):

Section(s) of Falsework/Temporary Works to be Struck (state gridlines & levels)

Details of Special Striking Conditions

Senior Temporary Works Co-ordinator

• I confirm that; the permanent works engineer has been consulted and has agreed that the permanent works supported by the falsework/temporary works detailed above are now self-supporting and I am satisfied that it is safe to strike/dismantle the falsework/temporary works detailed above.

• Name of Senior Temp. Works Co-ordinator (please print):

  Sign

Contractor Supervisor

• I confirm that I have inspected the falsework/temporary works detailed above, I am satisfied that it can be safely struck/dismantled and I will comply with any special striking conditions

• Name of Contractor Supervisor (please print):

  Sign

Project Leader

• I confirm that the permanent works engineer has been consulted and has agreed that the permanent works supported by the falsework/temporary works detailed above are now self-supporting I am satisfied that it is safe to strike/dismantle the falsework/temporary works detailed above.

• Name of Project Leader (please print):

  Sign