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CONTROL DOCUMENT

This control pack confirms that all preliminary assessments have been completed and that all of the following permits necessary to control the activities of either in-house employees or contractors are attached and will be signed and completed following a complete inspection of the work area.

PERMIT NUMBER
CONTRACTOR (Company)
CONTRACTOR (Employee Name)
LOCATION OF WORK (Exact)
DESCRIPTION OF WORK
Date Work to be Completed:
Time:
SPECIAL INSTRUCTIONS:
Risk Assessment Needed?:
Reviewed?
Method Statement Needed?:
Reviewed?
Permits Needed:
General Permit to Work
Hot Work Permit
Entry into Confined Space
Remote Working or Working at Heights
Working With Hazardous Materials
Electrical Permit to Work
Environmental / Pollution Risk
Plant Isolation
Excavation

Permission to Proceed with Work

I declare that all needed documentation has been received and reviewed and that all appropriate permits to work are contained within this pack and that permission is hereby granted for the work to proceed.

Signed:
Date:
Permit Controller:
Time:
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