Template

Work Permit and Task Safety Assessment

by Andy Pryer, from the Community

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.

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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
Site Authority to Work Template
This Site Authority to Work template helps control high risk activities through a formal permit and authorization process. Capture site details, location of work, brief scope, and responsible personnel. Reference risk assessments and method statements, and select applicable permits such as LV and HV electrical, fire and life safety systems, hot works, mechanical isolation, confined spaces, and working at height. Record start and end times, induction, approvals, and completion or cancellation to maintain a clear Safe System of Work.
by Luke Penrose, from the Community
Downloads: 10+
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Template
Hospital Permit To Work Template
This Permit To Work template helps hospitals authorize and control contractor and maintenance activities. It captures permit details, contractor and competent person information, work scope and location, and RAMS submission and approval. It links associated high risk permits including hot works, working at height, confined spaces, isolated and live equipment. The form includes approvals, declarations, signatures, and clear acceptance of responsibilities. It guides permit clearance and closure, and verifies completion, safety, and any fire stopping measures such as sleeves, collars, covers, and sealants. Security checks confirm permits returned and closed.
by Stephen Dawson, from the Community
Downloads: 10+
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Template
Pre-Task Confined Space Checklist and Permit
Use this pre-task confined space checklist and permit to conduct a thorough pre-entry review for permit-required confined spaces. Confirm job scope, hazards and risk assessment, isolation and lockout, ventilation and lighting, signage and access, communications methods, and atmospheric monitoring with calibration and logging. Select required equipment and PPE, and complete emergency and rescue planning details. Includes team briefing plus entrant and supervisor sign-off to verify training, conditions, and authorization before work begins.
by WPN Facilities, from the Community
Downloads: 10+
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Work Permit and Task Safety Assessment

About author

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Safety Work Permit Template

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