OHANET CLOSED PTW AUDIT

Auditor (Print) (Sign) Designation :- Date:-

Permit No:- Issue Date:- Dept :-

Equipment Worked on :- Area :-

Task :-

Critical Findings :-

Auditors Immediate Actions :-

PERMIT & CERTIFICATES Y N N/A Comments

1 Is description of work section full and accurate ?
2 Has the correct category of permit been used ?
3 Have all potential hazards been identified ?
4 Have all adjacent & associated work been identified ?
5 Have all required precautions been identified ?
6 Has the requirement for Risk Assessment been identified ?
7 Has the correct PPE / Safety equipment needed for the task been
identified ?
8 Have all supporting documents & procedures been included with the permit ?
9 Has the need for gas tests been correctly stipulated ?
10 Have all the appropriate signatures been obtained ?
11 Have all permits & certificates been correctly cross referenced ?
12 Has the isolated plant / equipment been correctly identified on the ICC ?
13 Has the reason for isolation been clearly identified on the ICC ?
14 Has the plant / equipment been correctly isolated ?
15 Have all isolations been locked ?
16 Have all isolations been correctly & clearly labelled ?
17 Have isolation points been fully and correctly defined on the ICC ?
Summary:-

PERMIT CANCELATION Y
N N/A Comments
18 Has the state of work completion been clearly defined ?
19 Has a site inspection been carried out ?
20 Has the work site been left safe & clean ?
21 Have all the appropriate authorities signed off the permit ?
Summary:-

Ingineur de quart

Name Sign Date Time

HSE Chef de service :-

Name Sign Date Time

Production superintendent

Name sign Date