Title Page
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Work Permit Audit (Blue Card)
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Site
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Conducted on
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Prepared by
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Location
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DESCRIPTION OF SAFE AND AT RISK SAFE: -- Permit at job site -- Safety Lead at job site -- Required PPE (as specified on the permit) -- Work being performed fits job scope -- Special Consideration Section completed by Safety Lead -- All workers signed on work crew roster -- Pre-Job safety meeting completed -- Key risks identified to work crew -- If confined space, excavation, or critical lift, additional permit attached AT RISK: -- Permit not present at the job site -- Safety Lead not present at the job site -- Required PPE (as specified on the permit) -- Work being performed is outside of the job scope -- Special Consideration Section not completed by the Safety Lead -- All workers not signed on work crew roster -- Pre-Job safety meeting not complete -- Key risks are not known by the work crew when asked -- No additional permit attached for confined space, excavation, or critical lift, when required -- Firewatch is required, but no equipment is on-site N/A -- This does not apply to this audit
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Permit
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Safety Lead
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PPE
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Job Scope
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Work Crew Roster
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Pre-Job Safety Meeting
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Key Risks
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Additional Permit
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Fire Watch
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Comments:
