MM16 — Contractors General Permit to Work

Part A

Work Details

Permit raised by *

Job title *

Name and address of contractor performing the work *

Contractor contact details

Valid from — date *

Valid from — time *

Valid to — date *

Valid to — time *

Location of work *

Full description of the work to be carried out *

Part B

Safety Precautions

All items must be checked before work commences. Mark each item as Required (Y/N) then confirm compliance.

Documents received before work commences:

Job specific risk assessment received Method statement received Liability insurance received Evidence of competency received Contractors induction completed

Job specific instructions or precautions

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