WORK PERMIT AUDIT CHECKLIST
Work Permit Audit Done By : Signature : Date of the Audit : / /
Department Audited : Signature of HOD of the Dept Audited :
Sr. No Check Point YES NO Details of noncompliance Action taken If "NO" Status
Are the permit issuers and receivers are
1 authorized to issue and receive the work
permit?
Are the hazard assessment is done as per
2 required of the permit system with
respect to site condition?
Are all columns are filled properly in the
permit book and register both e.g. job
description, names of persons involved,
3
isolation, tools and PPE required, date
and time of issue and expected date and
time of finish of work.
Is the isolation officer is trained and
4
authorized?
Are all sort of energies are isolated as per
5
LOTOV procedure?
Are the lock numbers of all affected
6
persons mentioned?
Is the housekeeping is done and ensured
that the equipment and the area is
7 rendered safe for operation before
surrendering the work permit by receiver
and cross checked by issuer?
Are the persons involved in the work at
8 height and confined space are trained
and authorized for such jobs?
Is the PAP talk related to the job is given
before start of the job and signature
9
taken from the working personnel on the
work permit?
Is the JSA made for critical jobs like roof
repair, confined space, work above
10
9meter height, and jobs involving more
than two departments.
Is the second copy of the permit is
11 available with the employee/contractor
at the site.
All the precautions mentioned in the
12 permit are actually taken at the site.
(Verify at the site).
Is the work permit is surrendered
13
immediately after completion of the job?
Rev No- 01 Date 17.01.2019