PERMIT TO WORK (PTW) —

How to use: Select a permit type below, fill in your site and company details, then click "Generate Permit to Work". Each PTW costs 1 credit and will be automatically saved to your Saved Docs page.

Supervisor:

Ph:

Email:

Company/Business Name:

Permit Issuer Name:

Permit Receiver Name:

Address / Site Location:

Permit Number:

Permit Start Date & Time:

Permit Expiry Date & Time:

📷 Site Photos & Work Area Sketches (Optional)

Attach photos of the work area, equipment, hazards, or a hand-drawn sketch. These will be included in the generated permit PDF. Tap the camera icon to take a photo directly on mobile.

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Select Permit Type

Select one permit type. Additional site-specific fields will appear below.

🔥 Hot Work Permit — Site-Specific Details

Hot Work Equipment to be Used:

Fire Watch Officer Name:

Fire Extinguisher Type & Location:

Atmosphere / Gas Test Result (LEL %):

Exclusion Zone Radius:

Pre-Work Checklist

Check Item	Yes	No	N/A
Work area inspected and combustibles removed or protected
Gas / atmosphere test completed and within safe limits
Fire extinguisher/s inspected and positioned within 2m of work
Fire watch officer briefed and in position
Hot work equipment inspected and in safe condition
Exclusion zone established and barricaded
PPE confirmed — welding helmet, gloves, protective clothing
Emergency procedures and assembly point confirmed
Post-work fire watch period confirmed (minimum 30 minutes)

🪜 Working at Heights Permit — Site-Specific Details

Maximum Working Height:

Height Access Method:

Anchor Point Inspection Completed By:

Rescue Plan & Equipment:

Pre-Work Checklist

Check Item	Yes	No	N/A
Fall protection system inspected and certified
Harness, lanyard and connectors inspected pre-use
Anchor points inspected and rated for load
Exclusion zone established below work area
Access equipment (EWP/scaffold) pre-start check completed
Weather conditions assessed — no work in winds over 50 km/h
Rescue plan confirmed and rescue equipment on site
All workers hold current Working at Heights training certificate

🕳️ Confined Space Entry Permit — Site-Specific Details

Description of Confined Space:

Standby / Rescue Person Name:

Oxygen Reading (%) — Safe: 19.5–23.5%:

LEL Reading (%) — Safe: below 10%:

CO Reading (ppm) — Safe: below 25ppm:

Rescue Equipment Available:

Pre-Work Checklist

Check Item	Yes	No	N/A
Atmospheric testing completed — O₂, LEL, CO within safe limits
Continuous atmospheric monitoring in place during entry
Space isolated from all energy sources
Forced ventilation operating prior to and during entry
Trained standby person positioned at entry point
Rescue equipment on site and standby person trained
Communication system established between entrant and standby
All entrants hold current Confined Space Entry training

⚡ Electrical Isolation Permit (LOTO) — Site-Specific Details

Isolation Point / Switchboard:

Lock / Tag Number:

Test Instrument Used:

Voltage Tested / Confirmed De-energised:

Pre-Work Checklist

Check Item	Yes	No	N/A
All energy sources identified and documented
Circuit isolated and lock/tag applied at isolation point
Voltage test confirms zero energy at work point
Stored energy (capacitors, springs, pressure) discharged
All affected workers notified of isolation
Insulated PPE (gloves, face shield) confirmed
Work carried out by or supervised by licensed electrician

🚧 Excavation & Trenching Permit — Site-Specific Details

Dial Before You Dig Reference No.:

Maximum Trench / Excavation Depth:

Shoring / Battering Method:

Services Located & Marked:

Pre-Work Checklist

Check Item	Yes	No	N/A
Dial Before You Dig completed and services located
Underground services marked on ground surface
Shoring or battering installed for trenches over 1.5m deep
Edge protection / barricading installed around excavation
Safe access / egress (ladder) provided into trench
Spoil placed minimum 600mm from edge of excavation
Atmospheric testing completed if confined space risk exists

🧊 Cold Work Permit — Site-Specific Details

Hazardous Area Classification:

Confirmation No Ignition Sources Present:

Gas / Atmosphere Reading Prior to Work:

Pre-Work Checklist

Check Item	Yes	No	N/A
Area classification confirmed and documented
Gas / atmosphere test completed — within safe limits
All tools confirmed non-sparking
No hot work permits active in adjacent areas
Fire detection systems active and functional
Emergency procedures confirmed with all workers

🔩 Pressurised Systems Permit — Site-Specific Details

System Type:

System Operating Pressure:

Isolation Point:

Pressure Confirmed at Zero (instrument used):

Pre-Work Checklist

Check Item	Yes	No	N/A
System depressurised, bled and drained
Isolation valve locked closed and tagged
Zero pressure confirmed with calibrated instrument
Residual stored energy (spring tension, hydraulic accumulator) released
PPE confirmed — face shield, chemical resistant gloves
All workers notified system is isolated

☣️ Asbestos Disturbance Permit — Site-Specific Details

ACM Type:

Licensed Asbestos Contractor:

Asbestos Removal Licence Number:

Disposal Method & Waste Facility:

Pre-Work Checklist

Check Item	Yes	No	N/A
Asbestos register consulted and ACM location confirmed
Licensed asbestos assessor engaged
Exclusion zone established and signage erected
P2 respirators and disposable coveralls confirmed for all workers
Asbestos waste bags (200 micron, labelled) on site
SafeWork / regulator notification completed (if required)
Air monitoring arrangements in place

☢️ Radiation Work Permit — Site-Specific Details

Radiation Source Type:

Radiation Safety Officer Name:

Dose Rate at Work Area Boundary:

Controlled Area Radius:

Pre-Work Checklist

Check Item	Yes	No	N/A
Radiation source logged in and out with RSO
Controlled area established, barricaded and signed
Dosimeters issued to all workers in controlled area
Survey meter calibration current and functional
Regulatory licence / approval current
Emergency procedures for source malfunction confirmed

🤿 Diving & Underwater Work Permit — Site-Specific Details

Maximum Dive Depth:

Dive Supervisor Name & Licence No.:

Standby Diver Name:

Vessel / Platform Details:

Pre-Work Checklist

Check Item	Yes	No	N/A
Dive supervisor present and licensed
Standby diver briefed and equipped
Diving medical certificates current for all divers
All diving equipment inspected and tested
Surface supply / umbilical checked and functional
Weather and water conditions assessed and acceptable
First aid and emergency decompression plan in place

🏚️ Demolition Permit — Site-Specific Details

Structure / Element to be Demolished:

Demolition Method:

Structural Engineer Approval Reference:

Hazardous Material Survey Status:

Pre-Work Checklist

Check Item	Yes	No	N/A
Structural engineer approval obtained in writing
Hazardous materials survey completed — ACM, lead paint, silica
All utilities isolated — electrical, gas, water, data
Exclusion zone established — no unauthorised persons within zone
Dust suppression measures in place
Demolition waste management plan confirmed
Plant operator holds current high-risk work licence

🏗️ Crane & Lifting Operations Permit — Site-Specific Details

Lift Type:

Crane Type & Safe Working Load:

Rigging / Lift Plan Reference:

Dogman / Rigger Licence No.:

Pre-Work Checklist

Check Item	Yes	No	N/A
Lift plan approved — signed by engineer for engineered/critical lifts
Ground conditions assessed — ground bearing capacity confirmed
Exclusion zone established — no persons under suspended load
Crane pre-start check completed
Rigging equipment inspected — within SWL and current tag
Dogman on site and in communication with crane operator
Wind speed checked — within crane manufacturer limits

🌙 Night Work / Out of Hours Permit — Site-Specific Details

Planned Work Hours:

On-Duty Supervisor Name & Phone:

Lighting Arrangements:

Emergency Contact / After Hours Number:

Pre-Work Checklist

Check Item	Yes	No	N/A
Site lighting adequate for safe work — no dark zones in work area
Emergency contacts confirmed and all workers briefed
Noise management / community notification completed if required
Lone worker / check-in procedure in place
First aid kit on site and first aider identified
Site secured — unauthorised access prevented

Remote & Isolated Work Permit

Work Location / GPS Coordinates

Nearest Emergency Services

Check-In Frequency

Communication Device(s) Available

Remote Work Checklist

Check-in schedule confirmed with site supervisor / emergency contact Communication device tested and fully charged prior to departure First aid kit appropriate for remote setting is on-site Written emergency response plan provided to all workers Vehicle(s) roadworthy and fuel levels adequate for round trip Weather forecast reviewed — conditions acceptable for remote work Overdue worker procedure confirmed with base / emergency contact

Chemical / Hazardous Substance Permit

Chemical / Substance Name

Dangerous Goods Class

SDS Reference / Location

Spill Kit Location

Chemical Handling Checklist

Safety Data Sheet (SDS) reviewed by all workers handling the substance Appropriate PPE (gloves, goggles, face shield, apron) selected per SDS requirements Spill kit checked and positioned within 10 m of work area Chemical storage compatibility verified — incompatible substances separated Adequate ventilation confirmed (natural or mechanical) for the work area Waste disposal procedure established and compliant with EPA requirements Eyewash station / safety shower location confirmed and within 10 seconds travel

Permit Authorisation

Both the Permit Issuer and the Permit Receiver must sign before work commences. This permit is not valid until both parties have signed.

✅ Permit Issuer

I confirm that the above hazards and controls have been assessed, all preconditions are met, and this permit is authorised.

Issuer Full Name:

Date & Time of Issue:

Issuer Signature:

📋 Permit Receiver

I confirm I have read and understood this permit, I accept responsibility for ensuring all conditions are met during the work.

Receiver Full Name:

Date & Time of Receipt:

Receiver Signature:

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Permit Close-Out — Included in Your PDF

Your downloaded PDF includes a Permit Close-Out Section at the end of the document. This section must be completed on-site by the Permit Issuer when all work covered by this permit has been finished.

The close-out section in the PDF contains the following fields to be filled in by hand on site:

Work Completed Satisfactorily — Yes / No checkbox
Close-Out Date & Time
Area Left Safe Confirmation
Outstanding Issues / Notes
Permit Issuer Signature & Printed Name

⚠️ This permit is not complete until the Close-Out Section is signed. The completed and signed permit must be retained on file for a minimum of 5 years in accordance with Australian WHS record-keeping obligations.