Todd Property Permit of Work Audit

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Add location
  Address

• Select date

  Date

• If any unsafe conditions are found, the work must be stopped and the issuing authority and the performing authority notified immediately.

  Safe

  At Risk

  N/A

POLICY

• Is there a clearly laid down policy for risk assessment of high-hazard operational and maintenance activities and their control procedures?

  Yes

  No

  N/A

• Are the objectives of the permit system clearly defined and understood?

  Yes

  No

  N/A

• Is the scope of work clearly specified?

  Yes

  No

  N/A

• Is the permit system flexible enough to allow it to be applied to other potentially hazardous work, apart from that which may have been specifically identified when the system was established?

  Yes

  No

  N/A

CONTROL

• Are responsibilities for the following made clear:<br>Management of the permit-to-work system?<br>Type of jobs subject to permit?<br>Control of contractors?<br>

  Yes

  No

  N/A

• Are the types of work, or areas where permits must be used, clearly defined and understood by all concerned?

  Yes

  No

  N/A

• Is it clearly laid down who may issue permits?

  Yes

  No

  N/A

• Is it clearly laid down how permits should be obtained for specific jobs?

  Yes

  No

  N/A

• Are people prevented from issuing permits to themselves?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Is the permit system recognised throughout the site or installation as being essential for certain types of work?

  Yes

  No

  N/A

• Are necessary risk assessments available for review?

  Yes

  No

  N/A

• Are identified hazards listed on the permit-to-work?

  Yes

  No

  N/A

• Are appropriate precautions listed on the permit-to-work (including clearly specified isolations)?

  Yes

  No

  N/A

• Is the operational time limit of the permit clear? (Are extensions properly authorised?)

  Yes

  No

  N/A

• Are certificates completed properly and appended to the permit?

  Yes

  No

  N/A

• Are other area or system activities cross-referenced correctly via the permit?

  Yes

  No

  N/A

• Are copies of permits, certificates and attachments legible?

  Yes

  No

  N/A

• Are signatures and initials traceable and legible

  Yes

  No

  N/A

• Are copies of permits and certificates posted at correct locations?

  Yes

  No

  N/A

• Are users briefed on the permit-to-work, and have they acknowledged understanding of requirements?

  Yes

  No

  N/A

• Do people know what to do in the event of emergency?

  Yes

  No

  N/A

• Are isolations appropriate for the task, clearly?

  Yes

  No

  N/A

• Are common isolations cross-referenced?

  Yes

  No

  N/A

• Are the right people aware of isolated equipment?

  Yes

  No

  N/A

• Is the area authority aware of the work?

  Yes

  No

  N/A

• Is the work carried out in conformance with the permit?

  Yes

  No

  N/A

• Are control measures and personal protective equipment appropriate for the task?

  Yes

  No

  N/A

• Are tools and equipment suitable and in good condition?

  Yes

  No

  N/A

• Are housekeeping standards satisfactory?

  Yes

  No

  N/A

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign