Free template

A permit to work template you can print today, with every section HSE says a permit needs

A permit to work is a form that makes one person confirm a dangerous job has been made safe before another person starts it, and makes both of them sign. This one has the ten sections HSE’s guidance lists, in the order they are used, on one sheet. It is free and there is no form to fill in to get it.

Or read it first

Prints as one A4 sheet. Fill in the bracketed fields before you photocopy it.

When you need one

The jobs a permit to work is for

Not every job. A permit is for work where the ordinary precautions of the site are not enough on their own and somebody has to confirm the extra ones before it starts. HSE’s guidance gives these as the usual cases.

Hot workWelding, cutting, grinding, brazing, anything with a flame or sparks outside a designated workshop. The most common permit on a manufacturing site and the one insurers ask about after a fire.
Confined space entryTanks, vessels, pits, silos, ducts. The Confined Spaces Regulations 1997 require a safe system of work, and a permit is the usual way of showing there was one.
Work on electrical systemsAnything needing isolation and proof of dead. The permit is where the isolation is recorded and where the person who made it signs.
Work at heightRoof work, fragile surfaces, work over machinery or open process. Not every ladder job, but anything where a fall is the hazard being managed.
Breaking containmentOpening pipework, vessels or process equipment that has held anything hazardous or under pressure.
ExcavationAnywhere buried services might be. The permit records that the drawings were checked and the scan was done.

1. The job

Location and plant or equipment

Description of work, and what is NOT covered by this permit

Carried out by (company and names)

RAMS received and reviewed ☐ Yes ☐ N/A Ref: ________

2. Hazards

☐ Hot work ☐ Confined space ☐ Electrical ☐ Work at height ☐ Breaking containment ☐ Excavation ☐ Moving machinery ☐ Hazardous substances ☐ Other: __________

Residual hazards of the plant or area

Hazards introduced by the work itself

3. Precautions and isolations

Isolations made (electrical, mechanical, process), how proved, and by whom

Other precautions (fire watch, gas test, ventilation, barriers, standby person, rescue)

Protective equipment required beyond the site standard

4. Authorisation and acceptance

Step	Statement	Name	Signature	Date and time
Authorisation	I confirm the isolations and precautions above are in place and this work may start. Valid from ____:____ to ____:____
Acceptance	I understand the work, its limits, the hazards and the precautions, and will work within them.

5. Extension or shift handover

Extended to	Precautions re-checked by	Signature	Accepted by	Signature
____:____
____:____

6. Hand back and cancellation

Step	Statement	Name	Signature	Date and time
Hand back	The work is complete or stopped, people and tools are withdrawn, and the area is left safe.
Return to service	Isolations removed and the plant is ready to return to service.
Cancellation	This permit is cancelled and may not be reused.

Built on the essential elements in HSE guidance HSG250. The issuer and the person doing the work must be different people. A permit past its time without an extension is not valid. Template from noonelite.com.

The sections

What each part of the form is for

Ten elements, from HSE’s guidance on permit systems. The form above compresses them into six numbered sections because a permit that runs to two pages does not get read.

Title and numberSo it can be referred to, cross-referenced to isolation certificates, and found again after the event.
Location, plant and workExactly where, exactly what equipment, exactly what is to be done and what is not. The limits matter as much as the description.
HazardsThe residual hazards of the plant, and the new hazards the work itself introduces. Two separate questions.
Precautions and isolationsWhat has been made safe, by whom, and how it is proved. This is the section the permit exists for.
Protective equipmentWhat the people doing the work must wear or carry, beyond the site standard.
AuthorisationA named, competent person signs that the precautions are in place and the work may start, within a stated time window.
AcceptanceThe person doing the work signs that they understand the job, the hazards and the precautions. A permit nobody accepted is a memo.
Extension and handoverWhat happens at shift change or when the work runs over. A permit that quietly continues past its time is the classic failure.
Hand backWork complete, area left safe, and a second signature that the plant is ready to go back into service.
CancellationThe permit is closed and cannot be reused. Until this is signed the job is still live.

Being straight with you

What a template does not do

A permit is a piece of a safe system of work, not the system. HSG250 is blunt about this: a permit issued by somebody who did not check the isolations, or accepted by somebody who did not read it, is worse than no permit, because everybody believes the job is controlled.
We are not health and safety consultants. What counts as high-hazard work at your site, who is competent to issue permits, and what precautions each job needs are decisions for your risk assessment and, ideally, somebody qualified.
This is a general permit. Sites with a lot of one kind of work usually run a specific form for it, a hot work permit in particular, with the precautions pre-printed. Start with this one and specialise when the pattern is clear.
Paper permits get lost, get extended by a phone call, and get closed by nobody. The permit module on our kiosk exists because of that, and it is in early access. If you have trades on site most weeks, the permit page is the one to read next; if you have a permit job a month, this sheet is fine.

The permit module, if paper is the problem The sign in sheets this pairs with Permits for a smaller site, the guide

Sources

Check any of this yourself

HSE, guidance on permit-to-work systems (HSG250)Where the essential elements on this page come from. Written for petroleum and chemical sites; the principles are general and HSE presents them that way.
HSE, permit to work systems as a technical measureA shorter description of what a permit system is for and what a good one contains.
Confined Spaces Regulations 1997Regulation 4: the safe system of work a permit normally evidences for confined space entry.
HSE, managing contractors: a guide for employers (HSG159)Where permits sit in the five steps of managing a contractor on your site.

General information about published HSE guidance, not health and safety advice. Which jobs need a permit at your site, and who may issue one, are decisions for your risk assessment.

Before you ask

The questions people ask about permits

Is a permit to work a legal requirement in the UK?

Not in general terms. No regulation says every site must run a permit system. What the law requires is a safe system of work: section 2 of the Health and Safety at Work etc. Act asks for it in general, and the Confined Spaces Regulations 1997 require one specifically before anyone enters a confined space. For high-hazard work a permit is how HSE expects a safe system of work to be evidenced, and its guidance, HSG250, is written on that basis. So the permit is not the duty; it is the standard way of discharging it.

What is the difference between a permit to work and a hot work permit?

A hot work permit is a permit to work for one kind of job, with the precautions that job always needs printed on the form: combustibles cleared or covered, fire watch during and after, extinguisher to hand, alarm zone isolated if needed. The general permit on this page covers any high-hazard job and asks you to write the precautions in. Sites that do hot work weekly usually run both.

Who can issue a permit to work?

Somebody your site has decided is competent to do it: they understand the plant, the hazards of the work, and how to confirm the precautions are actually in place before signing. That is normally a named supervisor or engineer, not whoever is at reception. The person issuing the permit should not be the person doing the work, because the point of the signature is a second pair of eyes.

How long is a permit to work valid for?

For the time written on it, and no longer. Most permits are issued for a shift or a working day. If the job runs over, the permit is extended by the issuer, with a signature and a new time, after checking the precautions still hold. A permit that continues because nobody closed it is the most common permit failure there is, which is why the form has an extension section and a cancellation section rather than just an end time.

Does a contractor need a permit to work?

A contractor needs one for the same jobs an employee would. The permit is about the work, not who is doing it. What changes with a contractor is that the risk assessment and method statement for the job usually arrive from their office, so the permit should record that RAMS was received and reviewed before authorisation. The contractor sign in sheet on the sign in template page has a column for that, and the two forms are meant to be used together.

Can a permit to work be electronic?

Yes. Nothing requires paper, and HSG250 discusses electronic systems. What matters is that the same elements are captured, the signatures are attributable to named people, the permit cannot be silently extended, and the record survives. An electronic permit is also readable by the people who need to know a job is live, without walking to the board. That is what our permit module does, and it is linked once on this page rather than sold on it.

Also asked of sites like yours

The other things somebody may ask you to evidence

Each of these is a page about one standard, one duty or one visitor, written the same way as this one: what it actually asks for, what an iPad at reception records towards it, and where it does not help.

When you are ready

If the paper permit has stopped being enough

Fifteen minutes on the phone. How many permit jobs a month, who issues them today, and what goes wrong. We will tell you straight whether the module is worth your time yet.

Book a 15 minute call

If the sheet is doing the job, keep using it. We will say so on the call.

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