Contractors Handback
Enter Permit No. and Press Enter Key
 

Declaration
I understand the hazards of this work and the precautions taken. These have also been explaind to the operative carrying out this work and I consider them competent to do so. I return this permit to the authorised person when the work has beeen safley completed/suspended.


Permit Reference
Contractor Company
Enter name

Complete all answers to questions below. Click to select required option
The works have been? Completed Not Completed Suspened
Work area cleaned, tidy and left safe? Yes No    
Fire watch complete? Yes No N/A
Isolations have been restored? Yes No N/A

Other Comments


Please sign within the box provided (Authoriser Signature)            Date:

Please be aware that an electronic copy of your signature will be stored in the Permit to Work Manager and will duplicated on printed copies of the permit for which it was provided. At no point will your signater be altered or used for any other purpose.