Template

Permit to Work HSE070 Rev 1

by Sean Ashton, from the Community

10+

Use this Permit to Work HSE070 Rev 1 checklist to plan and authorize high risk work. Capture site and contractor details, define job scope, review risk assessments and method statements, and set PPE requirements. Verify hot work precautions, confined space controls, lockout tagout and system isolation, ventilation, rescue and communication procedures, and fire watch. Record hazards and control measures, monitor the work area, and complete signatures for contractor and site acceptance to ensure compliance and safe completion.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

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
Permit to Work Checklist
Use this Permit to Work checklist to plan, authorize, and control high risk activities on site. It covers PPE requirements and verification, energy isolation and lockout tagout approvals, hot work controls with extinguishers, barricades, and post work fire watch, excavation planning and service locating, and working at heights training, equipment checks, and edge protection. Include inductions, worker counts, area lighting, hazard signage, and housekeeping. Close out by restoring alarms and isolations, cleaning the area, and confirming the site is safe to resume operations.
by Colin Handley, from the Community
Downloads: 0
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Template
Work Permit and Task Safety Assessment
Use this comprehensive work permit and task safety assessment template to plan and authorize contractor activities before work begins. It guides pre-work briefings, site protocols, and verification of method statements and risk assessments. Check PPE, tooling and equipment, signage, lifting, and manual handling readiness. Cover specialist hazards including hot work, confined spaces, working at height, and electrical isolation, with clear controls and permits. Include environmental checks for waste, noise, and spill response, plus site access, progress updates, and end-of-day tidy inspections. Capture signatures for permission to start and completion records.
by Andy Pryer, from the Community
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Template
Confined Space Permit to Work
This Confined Space Permit to Work template supports safe entry and maintenance in tanks, boilers, and process equipment. It guides teams through hazard identification, isolation and lockout/tagout, ventilation and temperature checks, gas testing and continuous monitoring, PPE requirements and intrinsically safe tools, standby and rescue arrangements, communication checks, and hot work controls. It includes sections for atmospheric tests, rescue plans, authorisation and acceptance, permit expiry, and hand-back and cancellation, helping organisations standardise confined space procedures and compliance.
by Richard Smith, from the Community
Downloads: 10+
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Permit to Work HSE070 Rev 1

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