Template

General Permit to Work Template

by Karen Hickman, from the Community

Use this general permit to work template to control hazardous tasks and ensure safe authorization of work. Record job details, tools and equipment, and any concurrent activities that may interact with the job. Identify hazards and, where needed, perform a risk assessment. Verify isolations and lockouts, adequate signage, worker competence or supervision, atmospheric testing, electrical shutdowns, breathing apparatus availability, and PPE readiness. Capture authorization and acceptance before work starts, then complete hand back and cancellation on completion with names, signatures, dates, and times. Adapt this checklist to your site rules for use across construction, maintenance, and industrial operations.

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Community

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
Safety Work Permit Template
This safety work permit template helps you control high risk work by formalizing request, review, and authorization. It guides supervisors and permit authorities through documenting the work activity, identifying high risk tasks such as hot work, confined space, excavation, plant isolation, work at heights, and live electrical work, and confirming risk assessments and controls are in place. Capture names, dates, approvals, and signatures, register the permit, and communicate scope and supervision requirements. Use it to verify controls before start of work, monitor hazards during the job, and close out with final sign off.
by Mohamed Elhassan, from the Community
Downloads: 10+
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Template
Electrical Permit to Work
Use this electrical permit to work template to manage safe electrical tasks from planning to hand back. Capture contractor details, job scope, location, start and end times, and PPE requirements. Verify competence, insurance, and RAMS or SSOW availability. Identify hazards, avoid live work where possible, apply isolation and LOTO, and confirm protection against shock and arc flash. Check tools, lighting, signage, and weather. Obtain authorization from a responsible person before works commence, brief all attendees, and document hand back and cancellation once equipment is reinstated. Suitable for port and logistics sites.
by Liam Reid, from the Community
Downloads: 10+
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Template
Permit to Work Authorization Checklist
Use this Permit to Work authorization checklist to review the scope of work, assess risks, and verify the right controls before a job begins. Capture job or permit number, site, date, preparer, and the person being reviewed. Perform a field risk assessment with the crew, confirm required permits, walk the area, and check PPE. Validate lockout tagout details, locks and tags, and confirm the reviewer recommends authorization. Record signatures and note if retraining is required.
by Brandon Van Laar, from the Community
Downloads: 20+
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Template
C3 Permit to Work
Use this C3 Permit to Work template to plan and control potentially hazardous work. The form guides responsible persons through job details, personnel competence, and general precautions, with detailed checklists for hot work, working at height, hazardous materials, and equipment isolation following LOTOTO. It covers electrical works verification, PPE, SOP and risk assessment confirmation, and communication requirements. Authorization and acceptance sections capture signatures for permit issue, acknowledgement by the responsible person and involved personnel, and handback and cancellation once the area is verified safe.
by Scott Denny, from the Community
Downloads: 0
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General Permit to Work Template

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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