University of North Texas

University of North Texas

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University of North Texas

Elevated Work Permit Request

Elevated Work Permits must be completed whenever:

  1. High work is to be performed within 25 feet of unprotected sides and edges, leading edges, unprotected holes and roofs that are 6 feet or more above an adjacent lower level;
  2. Guardrail or barricades systems are not available; and/or
  3. Work will be performed from an aerial lift or elevated work platform; or
  4. The use of portable stairs or ladders is infeasible.


Competent person - one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to workers, and who has authorization to take prompt corrective measures to eliminate them.


Warning Line System - Consisting of a cable or rope and stanchions installed parallel to and not less than 6 feet from the unprotected edge to warn personnel of the unprotected edge. High visibility flagging shall be installed on the cable/rope at intervals of not more than 6 feet. Safety Monitors are required any time a warning line system is employed without the use of Guardrails, Safety Nets, or Personal Fall Arrest Systems (PFAS).


Safety monitor - a competent person to recognize fall hazards and takes on the duties/responsibilities as follows:

  1. The safety monitor shall warn the employee when it appears that the employee is unaware of a fall hazard or is acting in an unsafe manner;
  2. The safety monitor shall be on the same walking/working surface and within visual sighting distance of the employee being monitored;
  3. The safety monitor shall be close enough to communicate orally with the employee; and
  4. The safety monitor shall not have other responsibilities which could take the monitor's attention from the monitoring function.

Requester

* Required
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Permit Date & Time

* Required
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Location

* Required

    PERMIT

    * Required
    * Required
    * Required

    POTENTIAL FALL HAZARDS

    * Required
    * Required

    METHOD FOR FALL PROTECTION

    * Required
    * Required

    RESCUE PLAN

    * Required
    * Required
    * Required

    SAFETY MONITORS

    Add Supporting Documents

    Add files to upload as supporting documentation along with your permit request.