Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • PTW Certificate Number
  • Personnel

Permit To Work Details

  • Ask the Control of Work Administer to demonstrate that accurate details of the PTW are recorded in the Control of Work Log?

  • Ask the PPW to demonstrate the work is being conducted as per the Description of Work recorded on the PTW Certificate?

  • Ask the RP if the relevant WRA, Procedures or Energy Isolation Certificates(s) have been reviewed and if they are referenced on the PTW Certification?

Potential For Conflicting Operations

  • Where the RP has identified that work specified in the PTW does conflict with current operations or other PTW, ask him to explain which effective "specific controls" have been agreed and implemented and who they had been communicated to?

  • Ask the RP how the affected Department Heads were made aware of the work requiring the PTW?

Person Performing The Work:

  • Ask when the worksite was inspected to ensure it was safe for the work to proceed? Ask what condition it was found in and if any additional controls were required following the inspection?

  • Ask for an explanation of the task, the hazards involved and any restrictions in place regarding the work scope or time scale of the task?

  • Handover - Ask the PPW if prior to commencing work the WRA was reviewed and how they ensured that all previous hazards identified were understood and that the existing controls were still effective? (Give details of any additional hazards identified and controls put in place at the time)

Responsible Person

  • Ask when the worksite was inspected to ensure it was safe for the work to proceed? Ask what condition it was found in and if any additional controls were required following the inspection?

  • Handover - Ask the RP if prior to commencing work the WRA was reviewed and how they ensured that all previous hazards identified were understood and that the existing controls were still effective? (Give details of any additional hazards identified and controls put in place at this time)

Area Authority

  • Ask how they ensured that the work was suitably planned and Risk Assessed before giving approval for the work to proceed?

  • If the work requiring a PTW has gone beyond 24 hrs, ask the Area Authority how the continued validity of the PTW was agreed and approved.

PTW Suspension

  • Ask the RP or the PPW if they are aware of the reasons why a PTW may be suspended and the actions they would be required to perform if a suspension was needed?

  • If this permit had been suspended how was reactivation authorized by the Area Authority?

Monitoring Of The Work Site

  • Is the Permit to Work Certificate displayed at the work site; and in a departmental area designated by the Area Authority?

  • If a Firewater or a Standby Watchman is required ask them what training they have completed and ask them to show you the completed checklist and explain how they ensured it had been followed?

  • Ask the PPW what specified control measures are in place and how they ensure they are effective for the task being carried out?

  • Ask the RP or PPW if a Permit to Work Certificate Continuation page has been utilized and if so to explain why this was required and to show that is kept with the Permit to Work Certificate?

Comments

  • Any additional comments?

  • Photo of site / or certificate

  • Action Required / OIM Comments:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.