Permit-to-work form

  • Release version: Xanadu
  • Updated January 30, 2025
  • 1 minute to read
  • Field descriptions on the form to request a permit-to-work.

    Table 1. Permit to work form
    Field Description
    Type One or more type of permit.
    Short description Description of the permit.
    Urgency Option used to select the urgency of the permit request.
    Risk assessment Field to add risk assessment associated with the request if any.
    Risk before controls Field is auto-populated when risk assessment is selected.
    Risk after controls Field is auto-populated when risk assessment is selected.
    JSA The JSA on the site that is associated with the request if any.
    Safety register Safety register relevant with the request if any.
    Inspection Option to add an inspection with the permit if needed.
    Work task Field to select the Health and Safety record relevant to the request if any.
    Location Field to select the location of the job.
    Work area Field to add more details about the location.
    Start date and time Field to select the shift start date and time.
    End date and time Field to select the shift end date and time.
    Approvals due by Field to select the permit approval date.
    Watch list Individuals to be aware of the status of the request.
    Requested for Individuals the permit is requested for.
    Description A brief summary of the permit.
    Comments Field to add any comments if needed.
    Attachment Option to add attachments related to this permit. Select the attachment icon ( Attachment icon) to add the attachment.