Safety & Permit Forms
The 25 forms that make up the airside safety, work authorization, electrical isolation and permit-to-work control layer of the AGL Engineering Forms & Templates system — ensuring no AGL work starts without appropriate authorization, risk assessment, isolation, competent personnel and defined work boundaries, and that work is not returned to service until closure and Safe-to-Energize controls are complete. Control philosophy: Plan → Identify Hazards → Assess Risk → Authorize → Isolate → Verify → Work → Inspect → Restore → Close Permit.
Where this fits — Division 13 is the safety gatekeeper between engineering authorization and physical AGL work, particularly for work on energized or potentially energized circuits, airside locations, and systems whose restoration can affect airport operations. Every permit here should trace back to an approved work order and forward into the Safety Closure, Permit Closure, and, for electrical assets, the Safe-to-Energize Certificate that release the work back to service.
A · Work Authorization & Permits
5 of 5 formsSAF-01 Work Permit Permit
Purpose
General authorization for carrying out defined work at an AGL project/site.
Key Fields
- Permit No. / Project / Airport / Location / Work area
- Date / Start time / Expected completion / Contractor
- Work supervisor / Authorized personnel
- Nature of work / Equipment / System / Asset ID / Drawing / Method statement
- Risk assessment, JSA and toolbox talk completed
- PPE identified / Work area barricaded / Access controlled
- Emergency arrangements confirmed / Communication established
- Permit issuer / Permit receiver / Safety representative / Start authorization
- Closure: work completed, area inspected, tools/materials removed, guards restored, permit closed
SAF-02 Electrical Work Permit Permit
Purpose
Specifically controls electrical work involving AGL electrical systems and equipment.
Key Fields
- Equipment: CCR, series circuit, isolation transformer, primary/secondary cable, ALCMS, signage, PAPI, approach lighting, distribution equipment
- Equipment ID / Circuit ID / Voltage / Current / Supply source / Isolation point / Work location
- Electrical isolation identified / LOTO applied / Isolation verified
- Test-for-dead completed where applicable
- Earthing/discharge requirements addressed
- Unauthorized energization prevented
- Electrical authorized person / Permit issuer / Permit receiver
SAF-03 Airside Work Permit Permit
Purpose
Controls work performed within operational airside areas.
Key Fields
- Airport / Runway-Taxiway-Apron / Work location / Work boundaries / Work timing
- Aircraft movement considerations / ATC-airport coordination
- Airside access authorization / Vehicle authorization / Radio communication
- Lighting requirements / FOD controls / Barricading-marking
- Personnel visibility / Escort requirements where applicable
- Work suspension triggers: aircraft movement, operational requirement, reduced visibility, emergency, ATC/airport instruction
SAF-04 Excavation Permit Permit
Purpose
Authorizes excavation or ground disturbance where underground AGL infrastructure may be present.
Key Fields
- Location / Dimensions / Depth / Purpose / Contractor / Supervisor
- Underground services: primary/secondary cables, earthing conductors, control/communication cables, drainage/services, other utilities
- Approved drawing reviewed / Underground services identified / Route marked
- Safe excavation method established / Equipment controls established
- Closure: excavation completed, cable/service condition verified, backfilling completed, area restored, permit closed
SAF-05 Hot Work Permit Permit
Purpose
Controls activities involving heat, flame, sparks or other ignition sources such as welding, cutting, grinding, or brazing.
Key Fields
- Fire risk assessment / Fire extinguisher / Fire watch
- Combustible material removed or protected / Gas cylinders secured
- Work area controlled / Suitable PPE
- Post-work fire inspection
- Closure: hot work completed, fire watch completed, area inspected, no residual fire hazard, permit closed
B · Isolation & Energy Control
3 of 3 formsSAF-06 LOTO Record Record
Purpose
Provides a controlled record of Lockout/Tagout applied to AGL equipment or circuits.
Key Fields
- Asset ID / Equipment / Circuit ID / Location / Work order / Permit No.
- Energy sources: electrical, stored electrical energy, mechanical energy, other applicable sources
- Isolation point / Device identification / Lock number / Tag number / Person applying lock / Date-time
- Isolation confirmed / Zero-energy condition verified where applicable / Authorized person confirmation
- Restoration: personnel clear, tools removed, guards restored, locks/tags removed per procedure, equipment returned to authorized condition
SAF-07 Electrical Isolation Certificate Certificate
Purpose
Formally certifies that specified electrical equipment/circuit has been isolated for safe work.
Key Fields
- Certificate No. / Equipment / Circuit / Isolation point / Source / Voltage / Location / Permit reference
- Supply disconnected / Isolation device secured / Lock-tag applied / Identification confirmed / Isolation verified
- Isolated by / Verified by / Issued to / Date-time
- Cancellation: only after responsible authority confirms restoration conditions are satisfied
SAF-08 Equipment Isolation Record Record
Purpose
Records isolation of a specific AGL equipment item before maintenance, testing, repair or modification.
Key Fields
- Asset ID / Equipment type / Manufacturer / Model / Location / Circuit-system
- Isolation point / Isolation device / Lock-tag / Date-time / Authorized person
- Work order / Permit / Maintenance activity / Personnel
- Restoration: equipment inspected, covers/guards restored, connections checked, personnel clear, equipment restoration authorized
C · Risk & Pre-Work Safety
5 of 5 formsSAF-09 Safety Risk Assessment Assessment
Purpose
Identifies hazards associated with planned AGL activities and establishes appropriate controls.
Key Fields
- Activity / Hazard / Cause / Consequence / Existing control
- Likelihood / Severity / Risk rating / Additional control / Residual risk
- AGL hazards: electrical shock, arc/electrical hazard, aircraft movement, vehicle movement, excavation, cable damage, FOD, night work, poor visibility, working near operational AGL systems, weather, manual handling, working at height where applicable
- Approval: work supervisor, safety representative, responsible engineer
SAF-10 Job Safety Analysis Analysis
Purpose
Breaks the work activity into individual steps and identifies hazards and controls for each step.
Key Fields
- Structure: Work Step / Hazard / Consequence / Control / Responsible
- Typical AGL activity: mobilization, airside access, work-area setup, equipment isolation, LOTO, testing/verification, maintenance/installation, testing, restoration, area clearance
- Prepared by / Reviewed by / Approved by / Date
SAF-11 Toolbox Talk Record Record
Purpose
Documents the safety briefing provided immediately before work.
Key Fields
- Date / Time / Location / Work activity / Permit No. / JSA reference / Supervisor
- Topics: work scope, hazards, risk controls, LOTO, PPE, airside rules, FOD, emergency arrangements, communication, stop-work authority
- Attendance: Name / Role / Company / Signature
SAF-12 Pre-Work Safety Checklist Checklist
Purpose
Verifies that all essential safety requirements are ready before work begins.
Key Fields
- Permit approved / Risk assessment approved / JSA available
- Toolbox talk completed / Competent personnel confirmed
- PPE available / Tools inspected / Test equipment suitable / Calibration valid where applicable
- LOTO requirements established / Emergency contacts available
- Airside coordination complete / FOD controls established / Work area controlled
- Final status: Safe to Start Work — YES / NO
SAF-13 PPE Checklist Checklist
Purpose
Verifies that personnel have the required personal protective equipment for the work.
Key Fields
- PPE: safety helmet, safety footwear, high-visibility clothing, safety glasses, gloves
- Electrical protective equipment as required / Hearing protection where required
- Fall protection where applicable / Other task-specific PPE
- Verification: PPE available, PPE suitable, PPE inspected, PPE correctly worn
D · Airside & Work-Area Control
3 of 3 formsSAF-14 FOD Inspection Record Record
Purpose
Controls Foreign Object Debris within the work area and surrounding airside environment.
Key Fields
- Work area / Runway-Taxiway-Apron / Date-time / Inspector
- Check: tools accounted for, cable pieces removed, connector parts removed, fasteners removed, packaging removed, scrap material removed, stones/debris removed, equipment/material secured
- Final status: FOD Area Clear — YES / NO
SAF-15 Airside Vehicle Checklist Checklist
Purpose
Verifies the condition and suitability of vehicles used for airside AGL work.
Key Fields
- Vehicle ID / Registration / Driver / Company / Date
- Checks: vehicle condition, brakes, lights, warning beacon, reverse alarm, tyres, mirrors
- Radio/communication where applicable / Fire extinguisher / First-aid equipment where required
- FOD/security check / Required permits
- Status: fit for use, defect identified, not permitted
SAF-16 Work Area Inspection Inspection
Purpose
Verifies that the work area is safe before, during and after work.
Key Fields
- Barricades / Signage / Access / Lighting
- Cable protection / Excavation protection / Equipment positioning
- FOD / Vehicle positioning / Personnel control / Emergency access
- Status: safe, correction required, work suspended
E · Emergency & Incident Management
6 of 6 formsSAF-17 Emergency Contact Sheet Sheet
Purpose
Provides immediately accessible emergency contact information for the work team.
Key Fields
- Contacts: airport emergency services, airport operations, ATC/appropriate airport coordination contact, fire/emergency service, electrical control authority
- Project manager / Safety officer / Maintenance supervisor / Contractor supervisor / Medical-emergency contact / Security
- Document control: project, location, revision, effective date
- Contact numbers populated from the approved airport/project emergency-contact list, not assumed in the form
SAF-18 Emergency Response Record Record
Purpose
Documents actions taken during an emergency occurring during AGL work.
Key Fields
- Date-time / Location / Permit / Work activity / Emergency type / Persons involved / Initial condition
- Response: work stopped, area secured, isolation applied, emergency services contacted, personnel evacuated, ATC/airport coordination initiated where applicable, first aid/emergency response, incident scene preserved as required
- Recovery: hazard controlled, equipment secured, area inspected, work suspended/resumed, further investigation required
SAF-19 Incident Report Report
Purpose
Formally records a safety or operational incident.
Key Fields
- Incident No. / Date-time / Location / Work activity / Permit / Personnel / Contractor / Equipment-assets involved
- Description: what happened, sequence of events, immediate condition, damage/injury information as applicable, witnesses, photographs/evidence
- Immediate action: work stopped, area secured, isolation, emergency response, notification
- Investigation: immediate cause, contributing factors, root cause, corrective action, preventive action
- Closure: investigation complete, actions completed, verified by, closed by
SAF-20 Near-Miss Report Report
Purpose
Records an event that could have resulted in injury, damage, operational disruption or other loss but did not.
Key Fields
- Near-miss No. / Date-time / Location / Activity / Personnel / Description
- Potential consequence / Immediate action
- Root/contributing factors / Corrective action / Preventive action
- Used as a leading safety indicator, not merely an administrative record
SAF-21 Safety Observation Observation
Purpose
Records positive or negative safety observations during work.
Key Fields
- Observation types: safe behavior, unsafe behavior, safe condition, unsafe condition, improvement opportunity
- Observation No. / Date / Location / Activity / Observation / Risk
- Immediate action / Recommended action / Responsible person / Closure
SAF-22 Safety Violation Record Record
Purpose
Formally documents non-compliance with safety requirements.
Key Fields
- Violation No. / Person-team / Contractor / Location / Date-time / Requirement violated / Actual condition / Evidence
- Classification: minor, major, critical
- Action: verbal correction, stop work, corrective action, retraining, escalation, formal investigation
- Closure: corrective action completed, verification, responsible authority, closure date
F · Closure & Return to Service
3 of 3 formsSAF-23 Safety Closure Closure
Purpose
Verifies that all safety requirements associated with a work activity have been completed before final closure.
Key Fields
- Work completed / Personnel accounted for / Tools removed / Materials removed
- FOD inspection completed / Work area restored / Excavations secured-closed
- Guards/covers restored / Temporary barriers removed only when safe
- Equipment condition verified / Outstanding hazards eliminated / Related permits closed
- Final status: Safety Closure — ACCEPTED / NOT ACCEPTED
SAF-24 Permit Closure Closure
Purpose
Formally closes an issued work permit after completion and verification.
Key Fields
- Closure conditions: work completed, work area inspected, personnel clear, tools removed, materials removed
- FOD check completed / Temporary arrangements removed / Equipment condition verified
- Isolation status addressed / Required testing completed
- Signatures: permit receiver, permit issuer, supervisor, safety representative where required
- Permit status: closed, suspended, cancelled, extended according to authorized procedure
SAF-25 Safe-to-Energize Certificate Certificate
Purpose
Formally confirms that an electrical AGL system/equipment is ready for controlled energization after installation, maintenance, testing or modification. One of the highest-control forms in this division.
Key Fields
- Certificate No. / Asset ID / Equipment / Circuit ID / Location / Work order / Permit No.
- Work completed, installation inspected, connections verified, torque verification completed where applicable
- Earthing verified / Insulation-continuity testing completed as applicable / Required functional tests completed
- Covers/guards installed / Tools removed / Personnel clear / Work area clear / FOD inspection completed
- Temporary earths/grounds addressed / LOTO clearance completed / Related permits addressed / Drawings-documentation updated
- Energization authorization: ready for energization YES/NO, authorized by, date-time, control authority/operator, witness where required
- Post-energization: energization completed, equipment operating normally, abnormal condition observed, alarm/trip observed, further testing required
- Final status: SAFE TO ENERGIZE / NOT SAFE TO ENERGIZE
How Division 13 Connects
These 25 forms build the control chain that runs from work scope through risk assessment, authorization, isolation, execution, inspection, closure and — for electrical assets — controlled energization, so that no AGL work starts unauthorized and nothing is returned to service unverified.
Master Safety Control Flow
The six categories in this division follow the control sequence from work scope to return to service:
Related Divisions
- Division 01 — Project Management Forms (work authorization, coordination, project responsibility)
- Division 02 — Design & Engineering Forms (drawings, design hazards, engineering controls)
- Division 04 — Installation Forms (installation permits and safe execution)
- Division 05 — Inspection Forms (work-area and completed-work verification)
- Division 06 — Testing Forms (safe testing and pre-energization verification)
- Division 08 — Maintenance Forms (maintenance permits, LOTO, equipment isolation)
- Division 09 — Failure Investigation Forms (incident/failure investigation)
- Division 10 — QA/QC Forms (NCR, corrective/preventive action)
- Division 11 — Asset Management Forms (asset isolation, restoration and lifecycle records)
- Division 12 — Spare Parts Forms (safe material handling and maintenance issue)
Frequently Asked Questions
Quick answers about the 25 Division 13 Safety & Permit forms, how they are grouped, and how they connect to the rest of the library.
Q1What is Division 13 — Safety & Permit Forms in the AGL Engineering Forms & Templates library?
Division 13 is a set of 25 safety & permit forms (SAF-01 to SAF-25) in the AGL Engineering Forms & Templates library. It is the airside safety, work-authorization, electrical isolation and permit-to-work control layer, ensuring no AGL work starts without authorization, risk assessment, isolation, competent personnel and defined work boundaries. The forms are grouped into 6 categories: Work Authorization & Permits, Isolation & Energy Control, Risk & Pre-Work Safety, Airside & Work-Area Control, Emergency & Incident Management and Closure & Return to Service.
Q2Which forms are included in Work Authorization & Permits, Isolation & Energy Control and Risk & Pre-Work Safety?
Work Authorization & Permits (5 forms): SAF-01 Work Permit, SAF-02 Electrical Work Permit, SAF-03 Airside Work Permit, SAF-04 Excavation Permit, SAF-05 Hot Work Permit; Isolation & Energy Control (3 forms): SAF-06 LOTO Record, SAF-07 Electrical Isolation Certificate, SAF-08 Equipment Isolation Record; Risk & Pre-Work Safety (5 forms): SAF-09 Safety Risk Assessment, SAF-10 Job Safety Analysis, SAF-11 Toolbox Talk Record, SAF-12 Pre-Work Safety Checklist, SAF-13 PPE Checklist.
Q3Which forms are included in Airside & Work-Area Control, Emergency & Incident Management and Closure & Return to Service?
Airside & Work-Area Control (3 forms): SAF-14 FOD Inspection Record, SAF-15 Airside Vehicle Checklist, SAF-16 Work Area Inspection; Emergency & Incident Management (6 forms): SAF-17 Emergency Contact Sheet, SAF-18 Emergency Response Record, SAF-19 Incident Report, SAF-20 Near-Miss Report, SAF-21 Safety Observation, SAF-22 Safety Violation Record; Closure & Return to Service (3 forms): SAF-23 Safety Closure, SAF-24 Permit Closure, SAF-25 Safe-to-Energize Certificate.
Q4Which permits are included in Division 13?
Five permits are included: the Work Permit (SAF-01) for general authorization, the Electrical Work Permit (SAF-02), the Airside Work Permit (SAF-03) for work in operational airside areas, the Excavation Permit (SAF-04) where underground AGL infrastructure may be present, and the Hot Work Permit (SAF-05) for activities involving heat, flame or sparks. Closed permits are recorded on the Permit Closure form (SAF-24).
Q5What is the difference between the LOTO Record, the Electrical Isolation Certificate and the Equipment Isolation Record?
The LOTO Record (SAF-06) is a controlled record of lockout/tagout applied to AGL equipment or circuits. The Electrical Isolation Certificate (SAF-07) formally certifies that specified electrical equipment or a circuit has been isolated for safe work. The Equipment Isolation Record (SAF-08) records isolation of a specific equipment item before maintenance, testing, repair or modification.
Q6What is the difference between a Safety Risk Assessment, a Job Safety Analysis and a Toolbox Talk Record?
The Safety Risk Assessment (SAF-09) identifies the hazards of planned activities and establishes controls. The Job Safety Analysis (SAF-10) breaks the activity into individual steps and identifies hazards and controls for each step. The Toolbox Talk Record (SAF-11) documents the safety briefing given immediately before work, supported by the Pre-Work Safety Checklist (SAF-12) and PPE Checklist (SAF-13).
Q7What confirms an electrical AGL system is ready to be re-energized?
The Safe-to-Energize Certificate (SAF-25) formally confirms that electrical AGL equipment is ready for controlled energization after installation or work. Before it, Safety Closure (SAF-23) verifies that all safety requirements for the activity have been completed.
Q8Can the forms in Division 13 be downloaded and filled in?
Yes. Each form has a Download as Word button that produces an uncontrolled sample Word template with letterhead, a document-control block, ruled entry fields and a three-tier approval table, ready to print or fill on-screen. Checklist-format forms such as Pre-Work Safety Checklist (SAF-12) download with a checkbox and a verified-by line for each item. The forms can also be searched by keyword or form ID.
Q9How does Division 13 connect to engineering authorization and airport operations?
Division 13 is the safety gatekeeper between engineering authorization and physical AGL work, particularly for work on energized or potentially energized circuits, airside locations, and systems whose restoration can affect airport operations. Every permit here should trace back to an approved work order and forward into Safety Closure, Permit Closure and, for electrical assets, the Safe-to-Energize Certificate that release the work back to service.
ISSUE THE PERMIT. UNDERSTAND THE RISK.
A safety permit form authorizes the work — but real site safety comes from understanding isolation procedures, live-circuit hazards and the risks specific to airfield ground lighting work.
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Please read before relying on any content on this page or on any template downloaded from it.
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