RME Authorized Permit Issuing Authority Authorized employee and annual refresher

• Site conducted

  EMA2

• HRO Activity Used

• Location

• Conducted on

  Date

• Authorized person’s name

• Authorized person’s Login

• Person who is reviewing the Demonstration (Manager or delegate)

• Date 01 EURME EU WHS: High Risk Operation - Permit To Work (Module 1) Completed

  Date

• Date 01-EURME-EU WHS: High Risk Operation-Permit To Work (Module 2) Completed

  Date

• 1. Have the Authorized Associate collected the Risk Assessment and Method Statement from the contractor for the activity to be performed and reviewed it

  Yes

  No

  N/A

• 2. Has the Authorized Associate identify all the High Risk Operations involved in the task?

  Yes

  No

  N/A

• 3. Has the Authorized Associate identified all the interference risks between the activity to be performed by the contractors and Amazon’s activities?

  Yes

  No

  N/A

• 4. For all the interference risks identified, were proper control measures identified and added/flagged in the permit to work?

  Yes

  No

  N/A

• 5. Has the Authorized Associate verified that all permit users have received the site induction orientation?

  Yes

  No

  N/A

• 6. Are all impacted amazon departments notified about the activity to be performed?

  Yes

  No

  N/A

• 7. Has the permit to work been discussed at work location with all permit users before the start of the activity?

  Yes

  No

  N/A

• 8. Have all required signatures been collected before the start of the activity?

  Yes

  No

  N/A

• 9. Is the authorized Associate aware that at least one daily check needs to be performed during the execution of the activity to verify that the contractor is following the instructions provided in the PtW?

  Yes

  No

  N/A

• Does the Authorized Associate know what to do in case the contractor scope of work changes? (Activity shall be stopped and PtW re-evaluated to assess if new risks have arisen)

  Yes

  No

  N/A

• I declare that I reviewed the Permit to Work application on the contractor activity indicated above with the authorized person and confirm that they demonstrated sufficient knowledge on the PtW process and that are competent to issue Permits as Permit Issuing Authority.

  Sign

• Date

  Date

• I declare that a Permit to Work demonstration was carried out on the contractor activity stated above and that I have understood and will follow the Amazon PtW procedure.

  Sign

• Date

  Date

The current requirement for Permit to Work Process in CF and ATS is as follows:

• 1) Completion of the EU WHS High Risk Operations - Permit to Work (BASIC) training and EU WHS High Risk Operations - Permit to Work (Authorized) training
  2) If KNET training passed, Completion of the Hands-on portion (this document)
  3) If demonstration passed, the person’s manager shall mark the KNET RME PtW Demonstration as completed