Permit To Work (Asbestos)

• Site conducted

  Select Main school 6th form Sports hall Spielmann including learning centre

  • Main school
  • 6th form
  • Sports hall
  • Spielmann including learning centre

• Conducted on

  Date

• Prepared by

  David Hughes

  Michael taylor

  Cliff Maxwell

  Keith Hallam

  Aidan Wilcox
• Location
  Address

• This permit to work is issued to the following person. No other work other than that detailed must be carried out.

• Work to Carry Out:

• Company Name:

• Date/s of work:

  Date

• Duration of Permit:

• Location/s of work-

• I acknowledge that I/we have examined the asbestos report in relation to the proposed area of work as defined by the Responsible Person in school, and that the work activities will not displace the asbestos materials. I hereby declare that no other work than that stated above will be carried out, and all precautionary measures will be adhered to:

  Sign

• Job title/Position

• Time: and Date:

  Date

♦Authorisation

• Name and Signature of person issuing permit :

  Sign

• Designation:

  Sign

• Time: and Date:

  Date

♦Clearance

• I hereby declare that the work stated above has/has not* been completed Details:

  Sign

• Designation:

• Time: and Date:

  Date

♦Cancellation

• All copies of this permit to work are hereby cancelled:

  Sign