Working at Height Permit

Working at Heights Permit

Permit ID

This working at heights permit can be used to enable you to implement a safe system for any work you plan to undertake at heights within the Airport Precinct. The permit can be used to verify that risks are sufficiently managed and the work at height is undertaken safely.

The permit will significantly reduce the risk of an incident occurring by ensuring that all persons are aware of the hazards and risks and take the necessary precautions. The permit will also prompt for worker competencies and has provisions for a work at height rescue plan.

Status

Application Date *

Company Conducting the Work *

Date of Work *

Date of Works End *

Airport *

Alice SpringsDarwinTennant Creek

Specific Location of Work *

Description of the Works *Working at Height – Where there is a risk of person being injured from falling from height or hit by a dropped object.

GENERAL

SAFE WORK METHOD STATEMENT

SWMS must be specifically for the Working at Height activity, demonstrating how fall restraint or equivalent will be achieved (generic SWMS will not be accepted)
The risk of falling objects should be assessed, preventative measures put in place and documented within the SWMS
The area below must be appropriately barricaded off and sign posted “WORKERS OVERHEAD”, this must be documented within the SWMS
Work Permits will not be issued without an approved SWMS

Upload SWMS *

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Has the highest level of control been chosen to control the risk? See below *

YesNo

Elimination: The first step is to consider whether you can completely remove the source of the hazard. For instance:

•Look for tasks that can be completed while workers are on the ground instead of working at height.

•Avoid working at height if the surface isn’t sturdy enough to support workers’ weight.

Substitution: If working at height is necessary, explore safer alternatives:

•Identify the safest location for the task. Consider using equipment like an EWP (Elevated Work Platform) or a Crane with Manbox.

Isolation: Implement measures to isolate workers from risks:

•Install height safety systems such as barriers to prevent access to hazardous areas (e.g., edges of roofs).

Engineer Controls: Consider re-engineering or making physical changes to equipment or work systems:

•Modify equipment design to enhance safety.

Is the work surface been assessed to carry the weight of workers and equipment and deemed suitable? *

YesNo

Have all team members been fully briefed on this working at heights activity and the team leader have formal working at heights training, if so how? *

YesNo

Please give details *

Is the area below appropriately barricaded off and sign posted “People Working Above?” *

YesNoNA

WORKING AT HEIGHT

Has fall restraint been considered over fall arrest to prevent free-fall? *

YesNo

If fall arrest systems are proposed instead of fall-restraint methods the proposal must be fully detailed and site inspected and ratified by a member of the Safety team.

Is your Rescue Plan within your SWMS *

YesNo

Please attach Rescue Plan *

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Where required, are anchor points above head height? *

YesNoNA

Is there a clear method of accessing/egressing the work location? *

YesNo

Has the fall protection equipment been inspected, tested and tagged? *

YesNoNA

Is there a designated anchor point or structure suitable for the attachment of fall protection equipment? *

YesNoNA

Comments

First Name *

Last Name

Email Address *

Mobile *

ADG REPRESENTATIVE DETAILS

Please reference your ADG representative contact below (e.g: project manager)

Full Name *

Select from dropdown list

Email *

Click Submit to forward your application through to ADG Safety for review and response. Please allow up to 2 business days for a response. For urgent requests please email safety@adgnt.com.au

ADG ASSESSMENT

Permit application assessment *

ApprovedNot ApprovedPending - More Information Required

CommentsThis information will be returned to the applicant and close the application off.

Reason Not Approved *This information will be returned to the applicant and close the application off.

Detail what information is required *This information will be returned back to the applicant to review and re-apply.

Full Name

Select from dropdown list

Email

Assessment Date *

Click Submit to complete the application and notify the Applicant of the Permit approval .

Click Submit to complete the application process and notify the Applicant of the non-approval.

Click Submit to reutrn the application to the Applicant for review and resubmission.

CAPTCHA *

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