Skip Navigation Links
 Missouri Department
 of Labor and
 Industrial Relations
Picture of workers
   Home    |    Workers    |    Businesses    |    Labor Laws
FAQs    |    Forms    |    Contact Us  
image for spacing
Division of Labor Standards
image for spacing

Sample OSHA Standard Specific Programs

ELECTRICAL HOT WORK PERMIT

TO BE REVIEWED BY TEAM LEADER PRIOR TO START OF WORK

VALID FOR TECHNICIAN AND DAY ISSUED ONLY

Date: Time: Maximum Voltage Present
Machine Number and Description:
 
 
Specific Reason Equipment Must Be Energized For Servicing?
 
 

Personal Protective Equipment Worn:

< > Flash Resistant Jacket

< > Insulating Gloves

< > Face Shield

< > Rubber Mats

< > Hard Hats

< > Other (List each additional item individually)

Time Work Completed Date
Technician's Name