Working at height permit — pre-work checklist
Checks to complete on each working at height permit: work at height unavoidable, collective protection first, access equipment inspected, fall arrest and rescue plan, fragile surfaces, falling objects, weather, nearby hazards and ground conditions.
15 itemsWorkplace safetyVersion 2Updated
This template covers a high-hazard activity. Adapt it to your site’s written procedures, your equipment and local regulations, and have it approved by a competent person before use. When imported, it lands for review: a checklist as a draft, a procedure as inactive.
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Category: Permit — pre-work checklist
- Permit type: Working at Height
- Filled in on each permit concerned, before the work starts.
Imported as a draft: it is not used until you review it and click Activate on the HSE template. Once activated, it is used on every new permit of this type and replaces the checklist in use.
Checklist items
Work at height cannot be avoided
The task cannot be done from the ground, with long-reach tools, or by bringing the item down.
Pass / FailCritical: a failure blocks the permitMeans of access
ChoiceRequired- Scaffold
- Mobile elevating work platform
- Mobile access tower
- Ladder or stepladder
- Roof
- Rope access
- Other
Working height (m)
NumberoptionalCollective protection is in place wherever possible
Guardrails, toe boards, safety nets: they protect everyone without any action from the worker, and come before harnesses.
Pass / FailCritical: a failure blocks the permitThe access equipment has been inspected
Scaffold or tower tagged by a competent person; platform pre-use check done by a trained operator; ladder checked and used only for short, light work.
Pass / FailCritical: a failure blocks the permitFall arrest equipment checked, where used
Harness and lanyard inspected and in date, anchor point rated for fall arrest, and enough clearance below for the arrest. Answer « Pass » if none is used.
Pass / FailCritical: a failure blocks the permitA rescue plan exists for a person suspended in a harness
Rescue within minutes: suspension in a harness quickly becomes dangerous. Equipment and trained people are on site. Answer « Pass » if no fall arrest equipment is used.
Pass / FailCritical: a failure blocks the permitFragile surfaces are identified and protected
Roof lights, fibre-cement or plastic sheets, ceilings: covered, guarded or marked out, never walked on. Answer « Pass » if there are none.
Pass / FailCritical: a failure blocks the permitThe area below is cordoned off and falling objects are prevented
Exclusion zone marked; tools tethered, toe boards or debris netting in place.
Pass / FailCritical: a failure blocks the permitWeather conditions allow the work
Wind below the limit of the platform or the scaffold sheeting, no ice, storm or poor visibility.
Pass / FailCritical: a failure blocks the permitNearby hazards are controlled
Overhead power lines, moving machinery, vehicle traffic, hot or toxic exhausts: isolated, or kept at a safe distance.
Pass / FailCritical: a failure blocks the permitThe ground can carry the platform or the scaffold: firm, level, no void or trench
Answer « Pass » if no platform or scaffold is used.
Pass / FailCritical: a failure blocks the permitWorkers are trained for the equipment used and fit to work at height
Pass / FailCritical: a failure blocks the permitPhoto of the access and the protections in place
PhotooptionalAdditional precautions or remarks
Free textoptional
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Licence
Official FreeMaint template, free to use and adapt inside your FreeMaint workspace. An adaptation may be shared in the library under CC BY 4.0; its page then credits this template.
Templates are general guidance. They do not replace the manufacturer’s instructions, your site procedures or applicable regulations.
Equipment: Workplace safety
Industries: Construction, Manufacturing, Facilities, Energy and utilities
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