Permit To Work

Assessment Paper II

Name:______________ Indicator: _______Position:_____________ Date:__________

Your task:

You are required to vet the prepared PTW, JHA and the supporting documents for
specific activity. Please highlight some deficiencies from the JHA worksheet & PTW
Form and write your remarks / findings on the answer sheet provided. You can use
the following parameters as guides:

JHA.
1. JHA task steps
2. Hazards are correctly identified
3. Control and Recovery measures are appropriately stated.

PTW
All information being stated in the relevant sections (12 altogether)
Requirement for Supporting Documents
 Permit To Work
Assessment Paper II

Name:______________ Indicator: _______Position:_____________ Date:__________

JHA WORKSHEET

Activity: _____________________________________________________

Findings

1.

2.

3.

4.

5.

6.

PTW APPLICATION FORM

Findings

1.

2.

3.

4.

5.

6,

OTHERS

1.

2.

3.