10 Work Permit Compliance Questionnaire Sheet
1. Is a Joint site inspection always required before issuing Work Permit?
a. Yes
b.No
c. Not if low risk. I fa joint site survey is not conducted because of low risk, the reason must be written on the work permit
d·. Only a Receiver has t.o survey the site.
2. Should receiver “sign” Work Permit if the permit does not address all of his safety concern?
a. No
b. Yes
c. Only if issuer request
d. Only if it is rush job
3. Can receiver «stop” work.
a. No
b. Only if issuer agrees
c. If receiver discovers that the original conditions change.
d. If receiver can not comply with work permit conditions.
e. The receiver should stop work if either C&D are true.
4. Does every work permit require a signature that Gas Test conducted?
a. Yes
b. No
c. If no hydrocarbons are present in an open area, Issuer & Receiver can agree that no Gas
Test necessary. The reason must be stated on the Work Permit & no signature in Gas
Test block required.
5. Can work in two different locations be covered on one Work Permit?
a. No
b. Yes
c. Only if agreed by issuer
d. Only with superintendent approval
6. Can two job.trades be covered on one work permit?
a.No
b. Yes
c. Only if issuer & receiver agree
d. Only with superintendent signature
7. Can Work Permit Receiver leave the site before the job completed?
a. No
b. Yes
c. He can only leave if a person knowledgeable about the job & its precaution is delegated.
d. He can only leave if the Receiver notifies the Issuer first.
8. For what distance from hot work site do sewers need to be covered.
a. 4 feet
b. 25 feet
c. 75 feet
d. 100 feet
9. Must all Issuers & Receivers have a valid certificate?
a. No
b. Yes
c. Not in remote areas
d. Only if’Receiver agrees
10. Can an Issuer delegate an “uncertified” person to sign the work permit for him?
a. Yes
b. No
c. Only if agreed by receiver
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