Download Permit Live Elecrical Form

PERMIT TO WORK ON LIVE ELECTRICAL
APPARATUS
(Testing & Commissioning)
Project:
Job Number:
Contractor:
Method Statement Ref:
Permit Number:
Description and Location of Works:
I certify that it is safe to work on the following Live Electrical Equipment: providing the following precautions have been
taken:
In the case of an emergency the equipment can be isolated and locked off* at the following locations:
The apparatus / Equipment is effectively earthed at the following points:
Permit issued by: (being the person authorised to issue the Electrical Permit from the Electrical Contractor)
Date:
Time:
I have read the above permit and fully understand the work to be carried out and the limitations of such work
Permit received by: (Person undertaking the works from
the Contractor)
Signature:
Date:
Time:
Bridgewater Contracts (Projects) Ltd|Permit to Work on Live Electrical Apparatus
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Permit authorised by:
Date:
Time:
(The permit must be authorised by a member of staff before works commences)
The work described above has been completed / suspended * and all men and materials under my control are clear of
the work area. No further work will be attempted.
* Delete as appropriate
Permit cleared
by:
Date:
Time:
Permit cancelled
by:
Date:
Time:
The Electrical Permit is:
1.
2.
3.
A form of declaration signed and given by a Senior Authorised Person
Given to a person in charge of work to be carried out on any earthed extra high or high voltage apparatus
To make known to all exactly what apparatus is dead, isolated from all live conductors, and has been discharged, in
its connection to earth and on which it is safe to work on.
Senior Authorised Person:
A competent person over 18 years, adequately trained and possessing current technical knowledge who has been
appointed in writing by his Manager to carry out specific operations and/or work on the system, including authority to
issue and cancel electrical permits to work.
Bridgewater Contracts (Projects) Ltd|Permit to Work on Live Electrical Apparatus
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