Page 80 - Cowdray Gold Cup 2021

Working at Height / Roofwork Permit
Risk Assessments Carried Out?
Work to be Carried Out
Is a Method Statement necessary / provided?
All Items to be Checked
Is Safe Access provided? What is the means of Access?.................................................................................... Is Suitable Edge Protection in place where these is a risk of falling?
Have Barriers been erected to prevent access to other areas of roof?
Is there safe means of getting materials and equipment to the roof work area?
Is the roof or areas of the roof know to be fragile?
Have fragile areas been barriered off or otherwise protected to prevent injury? Have any necessary COSHH Assessments been carried out?
Has a weather forecast been obtained?
Has suitable warning signage been placed?
Have Safety Harnesses been checked? (if required)
Has a secure anchorage been established? (if required)
Communications with ground established? (if required)
Working Team
1. 2. 3.
Enter the names of the working team
Signed: Signed: Signed:
4. 5. 6.
Signed: Signed: Signed:
This permit will remain in force until
Date Time
The following additional equipment/precautions are to be taken and used/observed
Permit Issued by: Name
Signed
Permit Issued to: Name
Signed
Cancellation
1. 2. 3. 4. 5.
Position
Date Time
Position
Date Time
I hereby declare that the work referred to above has now been completed.
All the personnel named in this permit have been withdrawn from the roof area. All tools, equipment and materials remaining on the roof have been secured. Further work on the roof will not take place unless a new permit to work is issued. Access to the roof area by unauthorised persons has been prevented.
Signed
Date Time
APPROVED