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CHECKLIST FOR EXAMINING WORK PERMITS

COMPLIANCE STATUS - ( YES / NO )


PERMIT NO & REMARKS
EQUIPMENT NAME 1 2 3 4 5 6 7 8

Legend:
1. Electrical Isolation & tagging Done
2. Mechanical isolation & tagging of equipment isolated
3. Key in Lock out Box .
4. Locking of breaker / Isolator module
5. Job Safety Analysis
6. Specialized permit issued/ not issued (Height work / Confined Space / Hot work / Floor Opening permit etc)
7. Proper entry in Permit Register
8. Proper closing of issued permits in SAP.

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