Covid-19 Close Working Permit

Covid-19 Close Working Permit
Stage 1 – Permit Information (Task Supervisor)
Project name
For YIT
valid Date from:
MånadDagÅr
Datum
valid Date to:
MånadDagÅr
Datum
Location of works:
Extent of works to be completed:
(limit to 15 mins. if possible):
Expected duration of task (limit to 15 mins. if possible):
Names of operatives working in close proximity (max 4no.)
Names of operatives working
Names of operatives working
Names of operatives working
Sisk Covid 19 Compliance Officer:
SISK responisble supervisor
Task Supervisor
name and company
RAMS NO.
name and company
SPA ID.
name and company
Other relevant information
Stage 2 – Provisions (Task Supervisor)
This task cannot be done at a later stage
yesNo
This task cannot be carried out with > 2m social distancing
yesNo
The work sequence cannot be altered to eliminate close contact
yesNo
the task cannot be done any quicker than the duration specified above
yesNo
The operatives been directly consulted
yesNo
The operatives been briefed on Covid-19 and the best hygiene pratices to minimise spread
yesNo
The appropriate additional PPE detailed in the SPA is availble
yesNo
Specific control measures for close contact work are included in the SPA
yesNo
That the operatives involved in the task do not have any symptoms of covid-19
yesNo
comments
IF YOU HAVE TICKED ANY RED BOXES ABOVE DO NOT PUT PEOPLE TO WORK AND CONTACT THE SISK PACKAGE MANAGER
Stage 3 – Issue of Permit
Task Supervisor: I understand the provisions of this Permit and the associated RAMS and SPA and will ensure works proceed in
accordance with these requirements. I will carry out a briefing at the workface on the contents of this Permit and ensure a copy is kept
Print Name:
Signature
Rensa
Date:
MånadDagÅr
Datum
Sisk Responsible Supervisor: I have reviewed the contents of this Permit and the associated SPA and confirm the works can proceed:
Print Name:
Signature
Rensa
Date:
MånadDagÅr
Datum
John Sisk & Son (Holdings) Ltd.
John Sisk & Son (Holdings) Ltd. 2019
All rights reserved. Document uncontrolled when printed.
symp
Type option 1Type option 2Type option 3Type option 4
Should be Empty:

Covid-19 Close Working Permit

Stage 1 – Permit Information (Task Supervisor)

Stage 2 – Provisions (Task Supervisor)

IF YOU HAVE TICKED ANY RED BOXES ABOVE DO NOT PUT PEOPLE TO WORK AND CONTACT THE SISK PACKAGE MANAGER

Stage 3 – Issue of Permit