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The permit issuing authority must complete this section, followed by carrying out a risk
assessment to satisfy that all hazards are identified and precautions in place are suitable. The
permit issuing authority must be competent person, he must specify;

• The nature of the work to be carried and the location or area.
• The names of each workers authorised to perform the task.
• The date and time of the work can Commence.
• The time limit for which the permit is valid for.

The control measures that are in place before, during and after the task.

Any Restrictions applicable – for example, the use of lighting in a confined space.

Any associated permits that are relevant.

The Permit issuing authority signs the permit to confirm that all necessary precautions are
implemented, and the work can start now. The issuing authority must include their name and
signature, along with date and time of when the permit is issued.

Receipt

The workers sign and accepts the permit to confirm that they fully understand the nature of
hazards, risks and control measures in place which they will comply.

Workers name and signature, along with date and time must be clearly mentioned.

Clearance / Return to Service

Workers sign in this permit section to confirm that they left the workplace in safe conditions,
confirming that the work is completed and ready to resume normal operations.

Cancellation

The issuing authority signs to accept the hand-back of the workplace from the workers followed
by work completion, also considered as cancellation of the permit, so that no further work is
allowed to undertake.

Extension

Extension/shift handover procedures – signatures confirming that checks have been made
to ensure that the plant remains safe to be worked upon, and that the new
acceptor/workers have been made fully aware of the hazards and precautions. Where an
extension to the work is involved, a new expiry time for the permit must be given

ENSIGN| Unit IG1 – Element 3 – Managing Risks – Understanding People and Processes 54