Permit-to-work request form
Description of the form to request a permit to work.
| Field | Description |
|---|---|
| Type | The type of permit. |
| Short description | Description of the permit. |
| Urgency | Option used to select the urgency of the permit request. |
| Risk assessment | The risk assessment associated with the request if any. |
| Risk before controls | Auto-populated when a risk assessment is selected. |
| Risk after controls | Auto-populated when a risk assessment is selected. |
| JSA | The job safety analysis ( JSA) on the site that is associated with the request if any. |
| Safety register | Any safety register relevant to the request. |
| Inspection | Option to add an inspection with the permit if needed. |
| Work task | The Health and Safety record relevant to the request. |
| Location | The location of the job. |
| Work area | The work area at the location. |
| Start date and time | The shift start date and time. |
| End date and time | The shift end date and time. |
| Approvals due by | The permit approval date. |
| Watch list | The individuals to notify about the status of the request. |
| Requested for | The Individuals the permit is requested for. |
| Description | Description of the permit. |
| Comments | Optional comments. |
| Attachment | Option to add attachments related to this permit. |