Working at Heights

Complete all sections. Fields marked * are required. Do not start work until this permit has been authorised and accepted.

Part A

Work Details

Permit raised by *

Job title *

Sertec employee or contractor performing work at heights *

Contractor details (if applicable)

Valid from — date *

Valid from — time *

Valid to — date *

Valid to — time *

Location of work *

Description and location of the Working at Height to be carried out *

Part B

All items must be checked before work commences. Mark each item as Required (Y/N) then confirm compliance.

Safety check Required? Y N

Persons performing the work are trained and authorised to work at height

Scaffold towers are properly constructed and erected by trained and authorised persons

The work area is defined with restricted access to unauthorised persons

Harness, shock absorber, rope, lanyard and fall arrester are inspected prior to use

The work area is restricted to vehicles not working in the area

Working outside: weather conditions are considered (wind speed, lightning)

There is 1 person on the ground for safety management

Persons in the work area and at ground level are wearing hard hats

People using platforms / MEWPs are trained and authorised to operate the equipment

Suitable ladders are used and are secured when in use (heavy duty, EN131)

Job specific instructions or precautions

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