Site safety template, free to use
Permit to work
General permit for high-risk activities: scope, isolation, precautions, issue, handback and cancellation.
Print it blank and fill it in on site, or use it as the structure for your own version. No sign-up, no email, no watermark. A competent person must adapt and approve any document before it is used on a real project.
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Permit to work
Free template from thebuildingsafetyact.com. To be reviewed and approved by a competent person.
Permit details
| Permit number: | Project / site: |
| Location of work: | Type of work: |
| Valid from (date and time): | Valid to (date and time): |
Description of work
Hazards identified
Precautions required before work starts
| Item | Yes | N/A | Comment |
|---|---|---|---|
| Isolation completed and proved | |||
| Area barriered and signed | |||
| RAMS briefed to all operatives | |||
| Atmospheric testing completed (if applicable) | |||
| Fire watch arranged (if applicable) | |||
| Emergency arrangements confirmed | |||
| Equipment inspected and certified |
Issue
| Issued by (name): | Position: |
| Signature: | Date and time: |
Acceptance by person in charge of work
| Name: | Company: |
| Signature: | Date and time: |
Handback: work complete, area safe, personnel clear
| Name: | Signature: |
| Date and time: |
Cancellation by issuer
| Name: | Signature: |
| Date and time: |
Free template from thebuildingsafetyact.com. This is a starting template, not professional advice. It must be reviewed, amended and approved by a competent person for the specific task, site and conditions before use. The Building Safety Act site and AI Metric Ltd accept no liability for its use.