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Permit To Work tool

Please fill ALL the fields below:

Step 1: General information
     Company in which the task will be carried out:
     e.g., Microsoft, Shell, etc.
     Facility in which the task will be carried out:
     e.g., Main warehouse, Head office, etc.
     Facility location:
     e.g., Huston, Texas
     Task description:
     e.g., Painting of the outside face of the office building
     How long will this task likely take (in days):
     This will determine the duration of the permit		 days

     Name of the team/company performing the task:
     e.g., Company Maintenance staff, Building works Co. Ltd., etc.

     Performing team/company authorized person (name):
     e.g., Jim Mackdonald

     Performing team/company authorized person (position):
     e.g., Foreman, Electrician, etc.

     Name of the person preparing this permit:
     e.g., John Smith

     Position of the person preparing this permit:
     e.g., Plant Supervisor, Camp Supervisor, etc.

     Name of the person monitoring the job on site:
     e.g., Tom Lee

     Position of the person monitoring the job on site:
     e.g., Plant operator, Process Engineer, etc.

     What is the type of the task?
     What will mostly be done during the task?

     Have you created a Permit To Work for this type of tasks      using this tool before?
     Will be used to creat permit reference number
Yes    No

     Is this permit relevant to another permit or certification      you created using this tool ?
     e.g., a cold work permit may be linked to an isolation certificate
Yes    No



    This tool utilizes public sector information published by the Health and Safety Executive and licensed

     under the Open Government Licence.