Template

Permit to Work Near LV Electrical Equipment

by Alan Taylor-Reed, from the Community

10+

This permit to work near LV electrical equipment helps teams plan and control work around energized or recently isolated systems. Record permit details, define scope and location, confirm qualifications, and verify isolations and lockout are in place. Capture risk assessments and method statements, prove dead, apply warning signage, and add additional earthing when required. The form supports extensions, sign-offs from the authorized person and workers, and documentation of isolation points across mechanical, electrical, and pipework to maintain electrical safety.

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Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
LV Electrical Permit to Work
Use this LV Electrical Permit to Work template to control and document low voltage electrical activities under a safe system of work. The checklist covers isolation from all energy sources, lockout and caution signage, proving dead with approved test equipment, earthing and cable identification, and warning signage on adjacent live equipment. It includes sections for authorisation by an authorised person, acceptance by a competent person, time extensions, completion, and permit closure, helping teams coordinate contractors and inform landlords or affected parties.
by Luke Penrose, from the Community
Downloads: 10+
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Template
Low Voltage Permit to Work
This low voltage permit to work template helps organizations plan and authorize electrical tasks safely. Capture permit details, scope of work, location, dates, and special conditions. Document access control and safety precautions including lock off, safe isolation, proving dead and test instruments used, earthing, and warning notices. The form includes declarations for the authorized person issuing the permit and the competent person accepting it, with names, positions, signatures, and timestamps. A closure section confirms work completion and withdrawal of personnel and equipment. Developed with reference to BS7671, this template supports consistent control of electrical work but should be reviewed for suitability to your site and jurisdiction.
by Phillipa Gregory, from the Community
Downloads: 10+
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Template
Permit to Work for Mechanical System Isolations
Use this Permit to Work template to plan and control mechanical system isolations. Capture precautions, barriers, risk assessments, method statements, and emergency procedures. Record authorizations, acceptance by the competent person, time extensions, and completion details to ensure equipment is safely returned to service. Aligns with Safe Systems of Work and helps keep unauthorized personnel out of high-risk areas.
by Luke Penrose, from the Community
Downloads: 10+
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Template
Electrical Work Permit Template
This Electrical Work Permit template helps teams plan and authorize electrical tasks safely. Capture permit numbers, work location and validity, and whether it combines with confined space or hot works permits. Verify trained and competent personnel, a current risk assessment, earthing, points of isolation, key retention, caution notices, and safety locks. Record authorization by the responsible contractor and site manager, plus worker sign-on/sign-off. Conclude with permit closure, confirming all equipment is returned and areas are left safe, including any controls left in place.
by Jeffrey Harders, from the Community
Downloads: 10+
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Permit to Work Near LV Electrical Equipment

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