ELECTRICAL WORK PERMIT
Permit Number
Vessel
e.g.: D or E /001/19
Comply with permit when carrying out electrical work on any equipment where there could be a hazard of
ELECTRIC SHOCK or ACCIDENTAL START / AUTO start of machinery or equipment.
IN CASE ELECTRICAL RISK IS ADDRESSED IN ONE OF THE OTHER PERMIT, A DUPLICATE PERMIT IS
NOT NEEDED.
Section 1: Scope of Work
To be Completed by Isolating Authority
Location:
Description of Work / Equipment / System / Circuit needing Isolation:
Working Voltage <1000 440 220 110 <110
Validity From Date: Time:
(Maximum 24 hours) To Date: Time:
T Enclosed Space Entry (PTW-01) High Voltage Work. (PTW-07)
a Hot Work (PTW-02) Work on Press. Pipelines / Vessels (PTW-08)
s
Cold Work (PTW-03) Work on Passenger Lift Equipment (PTW-09)
k
s Work at Height / Overside(PTW-04) Underwater Operations (PTW-10)
In Work on Deck In Adverse Wx (PTW-05)
cl
u
d Electrical Isolation Work (PTW-06)
e
s:
K Isolating Authority (E/O // C/E // 2/E)
Name / Rank
e (See Note)
y Team Leader Name / Rank
P
er Attendant (if required)
s
o
n
n
el
Task Performers
pl
a
n
n
e
d
Is Contractor involved?
Provide Details
Section 2: Preparations and Checks
Yes N/A
To be Completed by Isolating Authority
1. Risk Assessment done and mitigating actions taken as per hazards identified.
2. Toolbox meeting carried out.
3. Confirm this task not interfering with any other permit to work in force.
Risk from following energy sources identified:
4.
◻ Electrical shocks / sudden starting of machinery
PTW-06 01-May-2019 Page 1 of 3
◻ Hazardous moving machinery parts
◻ Contact with extreme hot / cold temperatures
◻ Sudden release of pressurized or hazardous fluid / gas in system
List the isolation points identified:
5.
6. Lockout / Tagout devices put on isolating points.
7. Confirm safety rubber (insulation) mat available for use.
8. Use insulated tools and specialised tools such as fuse pullers.
Secondary supplies and live circuits from interconnected equipment isolated.
9.
(If ‘No’, identify ALIVE CIRCUITS in ‘Special Precautions’ section below)
For electrical equipment in hazardous areas:
10. ◻ Strictly conform to maker’s instructions for installation, maintenance and repairs.
◻ Use only Ex-rated test equipment.
Test carried out to ensure positive isolation of the above risks and release of
11.
pressure.
For temperature-rated equipment relevant time lapse observed before opening.
12.
(Check on equipment identification plates or makers instructions)
In case of emergency work on live circuits:
◻ Chief Engineer to supervise the task including preparations and initial testing
◻ Task performer to wear insulated gloves rated for higher voltage than the
equipment.
13.
◻ Rubber blanket available to isolate the immediate work area from live
components.
◻ Safety attendant with knowledge of immediate isolation methods and emergency
response to electrical accidents appointed.
◻ Task performer not to wear metal wristwatch, jewellery and other metal fittings.
Note: Company procedures available in H&S chapter ‘Electrical Work Isolation’.
14. Relevant personnel informed prior commencement of work
Section 3: Special Precautions and Supporting Documents
To be Completed by Responsible Officer
Special precautions, if any:
Section 4: Acceptance and Authorisation
Following persons must sign upon completion of sections 1, 2 and 3
Person Sign Date Time
Isolating Authority
(E/O // C/E // 2/E)
Team Leader / Task Performer
Section 5: Completion and Cancellation
Date Time
To be Completed by Isolating Authority
Job completed
Person, material and equipment in use withdrawn.
There is no conflict with other application of LOTO devices
System restored and LOTO device removed.
Note: ONLY ISOLATING AUTHORITY will remove the LOTO device after job completion and when safe
to do so.
PTW-06 01-May-2019 Page 2 of 3
Isolating Authority Sign
(E/O // C/E // 2/E)
Note:
1. Electrical Officer (EO) will be isolating authority for all electrical isolations. If EO is not provided
or where the EO is the Team Leader / Task Performer, C/E or 2/E will act as isolating authority.
2. ISOLATING AUTHORITY and TEAM LEADER or TASK PERFORMER cannot be the same
person unless suitably relieved by another ISOLATING AUTHORITY and countersigning the
permit.
PTW-06 01-May-2019 Page 3 of 3