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Permit to work on electrical circuits and equipment
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Permit Checks
Mark the applicable column for each item: OK = Satisfactory | Fail = Not met | N/A = Not applicable. Record notes for any Fail.
| # | Check Item | OK | Fail | N/A | Notes / Action |
|---|---|---|---|---|---|
| Isolation Verification | |||||
| 1 | Isolation points identified from single-line diagram | ||||
| 2 | Circuit breaker / switch opened and locked out | ||||
| 3 | Personal lock and danger tag applied by each worker | ||||
| Test for Dead | |||||
| 4 | Voltage tester proved on known live source before use | ||||
| 5 | All phases and neutral tested dead at point of work | ||||
| 6 | Voltage tester proved again on known live source after test | ||||
| Earthing | |||||
| 7 | Temporary earths applied at point of work (where required) | ||||
| 8 | Earth connections secure and rated for fault current | ||||
| Arc Flash Risk Assessment | |||||
| 9 | Arc flash hazard analysis completed for switchboard | ||||
| 10 | Incident energy level determined and labelled | ||||
| 11 | Arc flash boundary established and marked | ||||
| 12 | Approach boundaries (limited and restricted) identified | ||||
| # | Check Item | OK | Fail | N/A | Notes / Action |
|---|---|---|---|---|---|
| PPE Requirements | |||||
| 13 | Arc-rated clothing worn (cal/cm2 rating matches hazard) | ||||
| 14 | Arc-rated face shield and safety glasses in use | ||||
| 15 | Insulated gloves with leather protectors (voltage-rated) | ||||
| 16 | Insulated tools rated for working voltage | ||||
| 17 | Insulating matting in place at switchboard | ||||
| Competent Person Details | |||||
| 18 | Electrical licence current and appropriate for work scope | ||||
| 19 | Competent person briefed on scope, hazards and controls | ||||
| 20 | Emergency rescue plan communicated (CPR-trained person on site) | ||||
| 21 | Re-energisation procedure agreed and documented | ||||
Declaration
I confirm that all isolation, testing and safety checks have been completed as indicated above. The electrical equipment is safe to work on under the conditions of this permit. Re-energisation must not occur until all locks, tags and temporary earths have been removed and all personnel accounted for.