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Cold Work Permit Form

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Cold work or plastic deformation of metals can cause extreme physical injury caused by over pressing and rolling. Other factors like electrical and mechanical hazards, like the use of hand and power tools, add up to the overall risk which workers may encounter during operation. Use Lumiform to customize this template based on your business needs and requirements.
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  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 4.8/5 stars on Capterra
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Cold Work Permit Form

Scope of works

Permit valid from

Permit valid to

Potential Hazards and Controls

Depressurizing

Draining

Adequate lighting

Safety tags and locks

Electrical isolation

Mechanical isolation

Exposure to moving/rotating machinery

Confined space

Fall protection

Standby man

Ventilate properly

Warning notice

Potential flammable/explosive atmosphere

Potential high temperature

Potential high pressure

Potential exposure to hazardous materials

Excavation works

Personnel Protective Equipment

Select PPE to be used

Other PPE

Work Authorization

Full Name and Signature of Issuer

Full Name and Signature of Performer