Permit-to-work template
A permit to work records controlled permission for a defined high-risk task, location and time. It identifies the required precautions, who checks them, who accepts the work, what changes suspend permission and how the plant or area is handed back. The blank form below is a starting structure. It is not an issued permit, and completing it cannot make unsafe work safe.
HSE's permit-to-work guidance explains that ordinary instructions are enough for many activities, while some work needs the extra control of a formal permit. Examples can include hot work, vessel entry, cutting into hazardous pipework and work requiring electrical or mechanical isolation. The decision to require a permit must follow the site and task risk assessment; there is no universal rule that every activity needs this form. A permit communicates between the site controller, supervisors, operators and those doing the work. It does not replace a risk assessment or method statement.
This is a general permit template. The existing hot works permit template owns the specific fire-producing-work intent. Confined-space entry, electrical isolation, excavation and other specialist work can need extra activity-specific authorisations, testing, rescue arrangements and competent sign-off. Do not use the generic fields as a substitute for those controls.
Decide whether a permit is appropriate
Before issuing, name the site controller and the permit issuer, define the work boundary, review the RAMS and identify interfaces with other tasks. Ask what could go wrong if a second contractor starts work, an isolator is removed, a valve is opened or a shift ends before the job is complete. The permit should carry only work that can be supervised and controlled within its stated window. Separate permits may be needed for different equipment or activities; related permits must be cross-referenced.
The issuer must verify required precautions before authorising work. This may include documented isolations, tests, guarding, ventilation, barriers, fire precautions, atmospheric monitoring, emergency cover and people with the right competence. The responsible person needs to understand the actual system and plant; a signature on a prefilled checklist is not a substitute for physical verification. The permit holder must be briefed and accept the conditions, and the team must know what triggers an immediate stop.
HSE's HSG250 guidance discusses planning, competence, risk assessment, communication, monitoring, handover and review of the permit system. It is framed around petroleum and chemical industries but gives general principles. A simple construction-site permit may be shorter, provided it clearly records the site-specific controls.
Copy-and-complete permit form
Status: DRAFT — NO WORK AUTHORISED until all required checks and approvals below are completed.
| Permit identity and scope | Entry |
|---|---|
| Permit number, version and linked permit numbers | [Enter] |
| Site, building, floor, equipment ID and exact work boundary | [Enter] |
| Client/site controller and operating department | [Enter] |
| Contractor, supervisor, permit holder and work team | [Enter names and contact method] |
| Exact task and prohibited/excluded work | [Enter] |
| RAMS, drawings, isolation certificate, COSHH and rescue plan references | [Enter document IDs/versions] |
| Issue date; valid from and valid until | [Enter local time and time zone] |
| Other activities/permits with a possible interface | [Enter and coordinate] |
| Pre-start precaution | Required? | Evidence/actual condition checked | Checked by and time |
|---|---|---|---|
| Scope and work area physically identified | [Y/N] | [Enter] | [Enter] |
| Energy and service isolations listed, applied, locked and verified | [Y/N] | [ID/test record; competent person] | [Enter] |
| Area tested or monitored for relevant atmospheres/contaminants | [Y/N] | [Method, result, limits, repeat frequency] | [Enter] |
| Fire, explosion and ignition controls | [Y/N] | [Task-specific controls] | [Enter] |
| Access, barriers, signs and protection of other people | [Y/N] | [Enter] | [Enter] |
| Plant/structure stability and equipment inspection | [Y/N] | [Enter] | [Enter] |
| Emergency, rescue, first aid and communication | [Y/N] | [Named people, equipment, test] | [Enter] |
| Welfare, lighting, weather and environmental controls | [Y/N] | [Enter] | [Enter] |
| Activity-specific permit/competence/authorisation | [Y/N] | [Enter] | [Enter] |
| Team briefing and competence confirmed | [Y/N] | [Attendees/time] | [Enter] |
Conditions of work: [Enter site-specific precautions, monitoring and any forbidden action. State the isolation boundary and who may alter it. State whether another activity must be stopped.] Stop-work triggers: [Examples: change in scope, loss of isolation, alarm, unsafe atmosphere, absent standby/rescue person, shift end, permit expiry, unexpected material, weather or conflicting work.] Emergency action: [Site-specific alarm, evacuation, rescue and who contacts emergency services.]
| Authority and acceptance | Name, signature/record and time |
|---|---|
| Permit issuer: I have checked the stated precautions and authorise only the described work within the stated window | [Enter after physical checks] |
| Permit holder: I understand the scope, conditions, stop triggers and handback process | [Enter before work] |
| Additional controller/isolating authority if required | [Enter] |
| Team briefing/acknowledgement | [Enter or attach record] |
The form should have an obvious way to identify a live, suspended, expired, cancelled or closed permit. A draft must never look like an approved one. Keep the permit available where the work is controlled, and give affected operators or other trades a way to see the relevant status. HSE advises that linked permits and simultaneous activities should be visible and coordinated.
During work, shift change and suspension
The holder should work only inside the agreed boundary, method and time window. The supervisor checks that controls remain in place. If conditions change, stop and put the work and plant in a safe state. Record the change, reassess, and have the appropriate authorised person reissue or amend the permit before continuing. Do not silently extend the expiry time because a job overran.
If work crosses shifts, record the state of the plant, incomplete work, isolations still applied, residual hazards and the identities of outgoing and incoming people. A new issuer or incoming holder should verify the conditions again. HSE's permit guidance specifically highlights safe shift handover and clear instructions when a job cannot be completed in one shift.
| Suspension/extension/handover | Entry |
|---|---|
| Stop time and reason | [Enter] |
| Work and equipment left in a safe state | [Describe and verify] |
| Isolations/barriers/testing still in force | [List evidence] |
| Change, new risks and revised RAMS/permit references | [Enter] |
| Outgoing holder and incoming holder briefing | [Names and times] |
| Reverification by competent issuer/controller | [Name/time] |
| New authorisation window and acceptance | [Enter only after checks] |
Close the permit and hand the area back
Completion has two separate decisions: the contractor declares that work is finished or safely suspended, and the controller confirms that the area/plant may be returned to its intended state. Check tools and people are accounted for, temporary equipment removed or controlled, guards restored, outstanding defects recorded and isolations removed only by the authorised process. Where testing or commissioning is required, record who owns it and whether a separate permit is needed. Do not close the permit simply because the authorised time expired.
| Close-out/return to service | Entry |
|---|---|
| Actual finish time; completed, incomplete or cancelled | [Enter] |
| Work area inspected, people/tools accounted for | [Result and checker] |
| Temporary controls and residual hazards | [Enter] |
| Tests, reinstatement and isolation removal authority | [Records/authorised person] |
| Contractor/holder handback declaration | [Name/time] |
| Site controller acceptance and return-to-service decision | [Name/time] |
| Linked permits notified/closed or still live | [Enter] |
HSE's COSHH permit guidance describes a permit as authorising specific people for specific work in a specified period, based on a risk assessment, with declarations for issuing, carrying out, handover and return to service where needed. The exact form must fit the employer's actual permit system.
Example: maintenance on a service line
A facilities contractor needs to replace a valve on a line that may contain a hazardous substance. The permit identifies the correct line and isolation points, records how it was drained and proved safe, names the isolation authority, and links to the RAMS and any relevant test record. A second team planning nearby hot work is identified before authorisation. If the line cannot be proven isolated, the permit remains a draft and the job does not begin. At completion, the contractor hands the work back; the controller independently manages reinstatement and tells the other team when their work may proceed.
The example is a logic check, not a ready-made isolation method. The actual substance, pressure, plant design and industry rules determine the technical procedure and who is competent to approve it.
Internal links and Complys boundary
The live permit-to-work software page owns the digital workflow and commercial software query. This template owns the blank-form/how-to-complete query. Link to RAMS for the task assessment and to the hot-work-specific template where fire-producing work is involved. The money page makes claims about QR acceptance, validity enforcement and audit trail; confirm each against current implementation before using those claims in the template CTA. Safe CTA: establish a competent permit process, complete the form for the real task and keep the issue-to-close record in the organisation's verified system.
Source, claim and writer-side QA register
| Material claim | Primary source | Boundary |
|---|---|---|
| Some higher-risk activities need formal permit control, while routine instructions suffice for many tasks | HSE permit-to-work systems | Risk/site decision; no universal permit requirement. |
| Permit is communication and not a replacement for risk assessment | HSE permit-to-work systems | Requires real safeguards and supervision. |
| Permit systems need roles, competence, linked permits, shift handover and return of plant | HSE HSG250 | General principles; specialist industry/site rules may be stricter. |
| Permit authorises specified people, work and period with precautions and declarations | HSE COSHH permit guidance | Example context; adapt to actual hazards. |
Intent/cannibalisation: no exact indexed general Complys permit template owner observed on 5 October 2026; existing hot-works template and permit software page have different tasks. Exact proposed route returned an internal error when checked; confirm repository and final canonical route before integration. Product truth: no feature, price or trial claim made in the CTA. Links: observed .co.uk owner, RAMS and hot-work template; repo routing check remains. Writer-side QA: usable form, issue/suspension/handover/close states, HSE primary sources, GB scope and metadata checked. Competent site, route, product and whole-page review remains before publication.