WORKING AT HEIGHTS PERMIT

F-EH-5.3
Rev. 0 01/29/2024

DATE OF APPLICATION: VALIDITY DATE: WAHP NO.: ________________

PROJECT NAME: JOB NO.: ____________ SHIFT: DAY NIGHT
JOB LOCATION (Lugar ng trabaho): GROUP: BBC NON-BBC:
DESCRIPTION OF THE WORK TO BE DONE AND ITS LIMITATION (Paglalarawan ng trabaho na dapat gawin at ang limitasyon nito):

WORKING AT HEIGHTS CONTROL MEASURES IMPLEMENTED: YES NO N/A REMARKS

1. Due consideration given to eliminate work at height tasks.
2. Edge protection provided wherever there is falling risks.
3. Fall prevention equipment are adequate and in good condition.
4. Travel restraint system used to exclude persons from falling risks.
5. All personnel are adequately trained to perform work at heights.
6. Safe means of access or egress provided.
7. Fall prevention equipment used to provide access or work platform.
8. Anchorage/lifeline installed and inspected by competent person.
9. All persons subjected to falling risks are equipped with PFAS*.
10. Hazards and risks assessment are conducted and
communicated. WORKING AT HEIGHTS CONTROL MEASURES
IMPLEMENTED: Assessment of Control Measure: YES NO N/A REMARKS
1. All reasonably practicable measures have been taken.
2. Verification of documents/interview workers/others.
Multiple Locations/ Extended Duration:
1. Hazards are common at various locations /time period.
2. Control measures are applicable and effective.
Site Survey with Supervisor:
1. All persons on site are protected from falling risks YES NO N/A REMARKS
2. Surrounding areas do not pose additional hazards.
APPROVAL OF WORK AT HEIGHTS:
1. Proper permit-to work evaluation has been complete.
2. No incompatible works that may pose additional hazards.
3. Control measures have been implemented effectively.
4. Fall from heights risks have been effectively mitigated.
REQUIRED DOCUMENTS: Method Statements
Others:

Permit applicant (Name/Signature/Date) Permit issuer (Name/Signature/Date) Permit approver (Name/Signature/Date) Permit receiver (Name/Signature/Date)
EXTENSION Working beyond 6:00 PM / (Magtatrabaho lagpas ng ala-sais ng gabi):
Date/Time
PERMIT APPLICANT
(Initials/Signature)
PERMIT ISSUER
(Initials/Signature)

HANDBACK (Nilagdaan ng mga tumanggap at pinatunayang natapos na ang gawain o itutuloy):

Permit applicant (Name/Signature/Date) Permit issuer (Name/Signature/Date) Permit receiver (Name/Signature/Date)

Note: Hindi pahihintulutan ang trabaho kung hindi masunod ang mga nabanggit sa itaas.
Kapag may emergency kaagad na itigil ang trabaho at magtungo sa Emergency Evacuation Area (Muster Point). Ang WAHP na ito awtomatikong
 WORKING AT HEIGHTS PERMIT
F-EH-5.3
Rev. 0 01/29/2024

mapapawalang bisa. Maghintay ng utos mula sa punong tagapamahala. Ibalik ang Permit sa Permit Issuer para mabigyan ng panibagong WAHP.