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    05 - Work at Height Permit

    Uploaded by

    winston11
    This work at height permit outlines the necessary safety precautions and procedures for a project. It provides details of the work such as the company, location, description of hazards, and precautions to take. The permit lists potential hazards like falling objects, unprotected edges, and adverse weather conditions. It requires wearing fall protection equipment, installing guardrails and toe boards, and avoiding overreaching. Atmospheric testing is needed if working in an enclosed space. Regular safety equipment and supervision are mandatory, and the permit must be extended if work continues past the authorized date or closed once complete.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    05 - Work at Height Permit

    Uploaded by

    winston11
    2K views1 page
    This work at height permit outlines the necessary safety precautions and procedures for a project. It provides details of the work such as the company, location, description of hazards, and precautions to take. The permit lists potential hazards like falling objects, unprotected edges, and adverse weather conditions. It requires wearing fall protection equipment, installing guardrails and toe boards, and avoiding overreaching. Atmospheric testing is needed if working in an enclosed space. Regular safety equipment and supervision are mandatory, and the permit must be extended if work continues past the authorized date or closed once complete.

    Original Description:

    work at height permit format

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    This work at height permit outlines the necessary safety precautions and procedures for a project. It provides details of the work such as the company, location, description of hazards, and precautions to take. The permit lists potential hazards like falling objects, unprotected edges, and adverse weather conditions. It requires wearing fall protection equipment, installing guardrails and toe boards, and avoiding overreaching. Atmospheric testing is needed if working in an enclosed space. Regular safety equipment and supervision are mandatory, and the permit must be extended if work continues past the authorized date or closed once complete.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views1 page

    05 - Work at Height Permit

    Uploaded by

    winston11
    This work at height permit outlines the necessary safety precautions and procedures for a project. It provides details of the work such as the company, location, description of hazards, and precautions to take. The permit lists potential hazards like falling objects, unprotected edges, and adverse weather conditions. It requires wearing fall protection equipment, installing guardrails and toe boards, and avoiding overreaching. Atmospheric testing is needed if working in an enclosed space. Regular safety equipment and supervision are mandatory, and the permit must be extended if work continues past the authorized date or closed once complete.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    WORK AT HEIGHT PERMIT

    Project Name: Permit No.:


    Date: From: To: Duration (Time): From: To:
    1. Details of Work:
    1.1 Name of Company:
    1.2 Location of Work:
    1.3 Description of Work:

    1.4 Person in Charge (supervisor): No. of Workers:


    1.5 Equipment & Tools
    to be used:
    Unsafe Access/Egress Incomplete Working Platform Fall From Height

    2. Hazard Incomplete Guardrails Overloading Working Platform Falling Objects


    Considerations
    Overreaching Adverse Weather Conditions Unprotected Edges

    Additional Hazards to be present: (for further, you may use back side of this page):

    Wear Full Body Harness Proper Access/Egress Proper Guard railing


    3. Precautions &
    Fire Protection Install Toe Boards Complete Working Platform Avoid Overreaching

    Additional Precautions to be taken: (for further, you may use back side of this page):

    4. Atmospheric Test: Gas test required? Yes No If yes record the results below
    Name Time Flammable 0% LEL Oxygen 23.5%-19.5% H2S Signature

    Remarks Regular basic PPE, availability of adequate supervision, method of statement, & risk assessment, etc., are mandatory.
    Person Authorized Permit Name Position Sign Date
    Permit Receiver from Sub-Contractor:
    Permit Issuer from HEES:
    Tick Permit Statement Person Name Sign Date
    Permit date is finished, job is still not Request (Receiver)
    finished, Please extend the date of Approved (Issuer)
    the Permit Permit extended up to:
    Request (Receiver)
    Permit is closed, job is completed
    Approved (Issuer)
    Permit Cancellation:
    Cancellation Remarks:
    Cancellation Requested By: Authorized By:

    HEES-PTW-05, REV-00

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