Basic Work Permit

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I. Work Permit Details

A. Permit Holder Information

Name:	[Your Name]
ID:	[Your ID Number]
Position:	[Your Position]
Department:	[Your Department]
Contact:	[Your Contact Information]

B. Company Information

Company	[Your Company Name]
Address:	[Your Company Address]
Phone:	[Your Company Number]
Email:	[Your Company Email]

C. Work Details

Project/Task:	[Project/Task Name]
Location:	[Work Location]
Duration:	[Work Duration]
Supervisor:	[Supervisor's Name]

II. Safety Instructions

A. General Safety Guidelines

• Wear appropriate PPE at all times.

• Follow all safety protocols and procedures.

• Report any hazards or incidents immediately.

B. Specific Safety Instructions

• [Specific Safety Instruction 1]

• [Specific Safety Instruction 2]

• [Specific Safety Instruction 3]

III. Emergency Procedures

A. Emergency Contacts

• Police: [Emergency Police Number]

• Fire Department: [Emergency Fire Number]

• Medical Emergency: [Emergency Medical Number]

B. Evacuation Plan

• Know the nearest exit routes.

• Follow emergency evacuation procedures.

C. First Aid

• Location of First Aid Kit: [First Aid Kit Location]

• Trained First Aid Personnel: [Names of Trained Personnel]

IV. Authorization

A. Permit Issuer

I, [Issuing Authority], hereby authorize [Your Name] to undertake the specified work.

B. Permit Holder Acknowledgment

I, [Your Name], acknowledge that I have read and understood the safety instructions and emergency procedures outlined in this permit. I agree to comply with all regulations and requirements.

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This permit is valid from [Start Date] to [End Date].

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[Your Name]

Date: [Date]

Note: This permit is subject to revocation or modification at any time by the issuing authority.

Work Permit Templates @ Template.net