Permit To Work Form

The permit supports the Permit to Work Procedure and permitting system, and is used as the general authorisation to undertake activities that require detailed planning.  The Permit is required for the following activities:

• Tasks that have the potential to impact on any operational process, equipment or adjacent work activities.
• Tasks that have the potential to result in a physical change to the work environment (e.g. scaffolding, excavation).
• Work requiring any isolation of energy or substances, or pressure testing.
• Work requiring a Subsidiary Permit (e.g. Confined Space Entry Permit, Hot Work Permit, Excavation and Penetration Permit, etc), or a Critical Lift Plan.
• Work where there is a risk of exposure to dangerous goods.
• Work within an electrical exclusion zone.
• Work where personnel are not assessed competent to perform the task.

The Permit is issued to:

• Give permission to commence work
• Communicate the impacts and implications of the work being undertaken
• Ensure all hazards are identified and the associated risks are adequately controlled to reduce the risk to an acceptable level.
• Detail how equipment should be positively isolated and worked on safely.
• Identify and record the task being undertaken, its location, and the people carrying it out.
• Ensure workers are aware of plant or equipment isolation and availability.