QA/QC  › Generic Master Forms  › Work Permit
Form · QC-GEN-FRM-012
Work Permit
29 checkpoints across 7 sections. Before commencing any high-risk or specialized work: hot work (welding, cutting, grinding), confined space entry, work at height > 1.8 m, excavation, electrical work, temporary structures, and any work identified as High or Extreme risk. Permit must be issued and accepted before work starts. Close-out must be completed before permit is considered closed.
29 Checkpoints
7 Sections
Per hazardous work activity; can issue multiple permits per day on active sites; typically 1-5 permits per week depending on activity intensity
Safety Officer / HSE Manager, Site Supervisor

Checklist Preview

S.No.CheckpointIS RequirementStatus
A. Permit Details
A1Permit Type - Select: (1) General Work Permit, (2) Hot Work Permit, (3) Confined Space Permit, (4) Height Work Permit, (5) Excavation Permit, (6) Electrical Work Permit, (7) Temporary Structure Permit
Acceptance: Type clearly selected; determines which sections are mandatory
Mandatory
OK
NC
NA
HOLD
A2Permit Validity - State valid from date and to date (and time). Example: Valid from 10-Mar-2026 06:00 AM to 10-Mar-2026 06:00 PM (12-hour permit). No work beyond validity period without permit extension
Acceptance: Validity period realistic and bounded; timestamp included
Mandatory
OK
NC
NA
HOLD
A3Validity Extension - If work extends beyond initial permit validity, complete extension section. New dates, reason for extension (e.g., work took longer than planned), additional safety precautions if conditions changed
Acceptance: Extension documented with authorization; conditions re-assessed if duration changes significantly
Conditional
OK
NC
NA
HOLD
B. Work Description
B1Activity Description - Detailed description of the hazardous work. Example for hot work: Structural steel welding of column base plate connection. Joint type: Fillet weld. Welding code: IS 801:2007. Equipment: Gas tungsten arc welder (GTAW), 250 A
Acceptance: Description specific and technical; scope clearly bounded
Mandatory
OK
NC
NA
HOLD
B2Exact Location - Precise location on site with grid/level reference. Example: Grid C/2, Level +5.5 m, North Face, Column C-2 connection area. Distance from other activities noted (e.g., 10 m away from concrete curing area)
Acceptance: Location uniquely identifiable; traceable on drawings; hazard zones defined
Mandatory
OK
NC
NA
HOLD
B3Equipment to be Used - List all equipment, machinery, and tools required. Specify model/specifications. Example: ESAB Warrior 500i Welder, Miller Bobcat 250 Generator, pneumatic angle grinder, bench vise, lifting lug
Acceptance: Equipment list complete; specifications noted; condition verified
Mandatory
OK
NC
NA
HOLD
B4Number of Workers & Supervisor - State number of workers performing the work. Name and designation of site supervisor/foreman overseeing the work. Supervisor must be present throughout permit validity period
Acceptance: Headcount realistic; supervisor identified and authorized; continuous supervision confirmed
Mandatory
OK
NC
NA
HOLD
C. Hazard Assessment (Reference Risk Assessment Form)
C1Identified Hazards - Reference the Risk Assessment form. List major hazards identified. Example for hot work: (1) Fire hazard from hot sparks and molten metal, (2) Eye/skin burn from arc radiation, (3) Inhalation of welding fumes, (4) Electrical hazard from equipment
Acceptance: Hazards match risk assessment; critical hazards listed; no omissions
Mandatory
OK
NC
NA
HOLD
C2Risk Level (from assessment) - State the overall risk level: Low / Medium / High / Extreme. High and Extreme risk work requires mandatory controls and hot work permit. Example: Welding at height and near wood formwork = High risk
Acceptance: Risk level consistent with assessment; High/Extreme automatically triggers additional requirements
Mandatory
OK
NC
NA
HOLD
C3IS Code References - List applicable IS codes and specific clauses. Example: IS 801:2007 (Structural Steel) - Clause 6.1 Welding Quality, IS 3043:1987 (Electrical Safety) - Clause 5.2 Welder Equipment Grounding
Acceptance: Codes accurately cited with clause references; control measures tied to code requirements
Mandatory
OK
NC
NA
HOLD
Showing 10 of 29 checkpoints ·
A. Permit Details
A1Permit Type - Select: (1) General Work Permit, (2) Hot Work Permit, (3) Confined Space Permit, (4) Height Work Permit, (5) Excavation Permit, (6) Electrical Work Permit, (7) Temporary Structure Permit
Mandatory (Generic)
Type clearly selected; determines which sections are mandatory
OKNCNAHOLD
A2Permit Validity - State valid from date and to date (and time). Example: Valid from 10-Mar-2026 06:00 AM to 10-Mar-2026 06:00 PM (12-hour permit). No work beyond validity period without permit extension
Mandatory (Generic)
Validity period realistic and bounded; timestamp included
OKNCNAHOLD
A3Validity Extension - If work extends beyond initial permit validity, complete extension section. New dates, reason for extension (e.g., work took longer than planned), additional safety precautions if conditions changed
Conditional (Generic)
Extension documented with authorization; conditions re-assessed if duration changes significantly
OKNCNAHOLD
B. Work Description
B1Activity Description - Detailed description of the hazardous work. Example for hot work: Structural steel welding of column base plate connection. Joint type: Fillet weld. Welding code: IS 801:2007. Equipment: Gas tungsten arc welder (GTAW), 250 A
Mandatory (Generic)
Description specific and technical; scope clearly bounded
OKNCNAHOLD
B2Exact Location - Precise location on site with grid/level reference. Example: Grid C/2, Level +5.5 m, North Face, Column C-2 connection area. Distance from other activities noted (e.g., 10 m away from concrete curing area)
Mandatory (Generic)
Location uniquely identifiable; traceable on drawings; hazard zones defined
OKNCNAHOLD
B3Equipment to be Used - List all equipment, machinery, and tools required. Specify model/specifications. Example: ESAB Warrior 500i Welder, Miller Bobcat 250 Generator, pneumatic angle grinder, bench vise, lifting lug
Mandatory (Generic)
Equipment list complete; specifications noted; condition verified
OKNCNAHOLD
B4Number of Workers & Supervisor - State number of workers performing the work. Name and designation of site supervisor/foreman overseeing the work. Supervisor must be present throughout permit validity period
Mandatory (Generic)
Headcount realistic; supervisor identified and authorized; continuous supervision confirmed
OKNCNAHOLD
C. Hazard Assessment (Reference Risk Assessment Form)
C1Identified Hazards - Reference the Risk Assessment form. List major hazards identified. Example for hot work: (1) Fire hazard from hot sparks and molten metal, (2) Eye/skin burn from arc radiation, (3) Inhalation of welding fumes, (4) Electrical hazard from equipment
Mandatory (Generic)
Hazards match risk assessment; critical hazards listed; no omissions
OKNCNAHOLD
C2Risk Level (from assessment) - State the overall risk level: Low / Medium / High / Extreme. High and Extreme risk work requires mandatory controls and hot work permit. Example: Welding at height and near wood formwork = High risk
Mandatory (Generic)
Risk level consistent with assessment; High/Extreme automatically triggers additional requirements
OKNCNAHOLD
C3IS Code References - List applicable IS codes and specific clauses. Example: IS 801:2007 (Structural Steel) - Clause 6.1 Welding Quality, IS 3043:1987 (Electrical Safety) - Clause 5.2 Welder Equipment Grounding
Mandatory (Generic)
Codes accurately cited with clause references; control measures tied to code requirements
OKNCNAHOLD
Showing 10 of 29 ·
Inspection Sign-Off
Permit Issued - Work May Proceed
Permit Denied - Work Cannot Proceed
Permit Extended - Validity Extended Per Close-Out
Permit Closed - Work Completed and Area Safe
Name / Sign / Date
Name / Sign / Date
Name / Sign / Date