Permit To Work No.: - 1-General Information - 4 - Additional Precautions
Permit To Work No.: - 1-General Information - 4 - Additional Precautions
-8- Cancellation
Competent Person Signature: Issuing Authority Signature:
A (3) 1.016
Electrical Isolations
Atmospheric Checks
Other (Specify)
A (3) 1.016
-4- Additional Precautions
Precautions in addition to those stated in the method statements, risk assessments and COSHH assessment must be stated here.
-8- Cancellation
The Competent Person and Issuing Authority from sections 6 and 7 respectively must sign, date and enter the time here, when the task (identified in section 1 is completed. Notes 1) No other person should cancel the permit to work. 2) All times to be entered on the Permit to Work must refer to the 24hr clock. Additional Information When current, copies of the Permit to Work should be posted locally to the work area and a copy kept with the issuing authority. Expired Permit to Work forms require to be kept for record purposes.