1. Ref : SOP 3 - PORMP Rev B
Permit to Operate Ride-on Mobile Plant
Contract No.: C Project Name: Daily Permit : W/C Monday
Plant type: Make: Model: Serial No. / Vehicle ID
Operator – Daily Plant Check & Briefing (Please enter either ( √ ) ( X ) or ( N/A )
In signing below I confirm that I have undertaken the following Monday Tuesday Wednesday Thursday Friday Saturday Sunday
checks in accordance with the manufacturer’s instructions.
Steering system
Braking systems (e.g. operation of brakes & level of brake fluid)
Seat & lap belts
Tyres (e.g. condition & pressure)
ROPS & FOPS (e.g. Roll-over & Falling object protection)
O
360 vision (e.g. mirrors &/ or cctv)
Lights & indicators
Windscreen (e.g. visibility, washers & wipers)
Hydraulic system (e.g. pipes, hoses, leaks & levels)
Warning devices (e.g. horn, reversing alarms, flashing beacons & ASLI
Safety devices (e.g. quick-hitch pins, PTO shaft guards & interlocks)
Signature (Plant Operator / Designated ‘Key Holder’ if multi-user)
Miller Construction – Daily Permit Issue (Please enter either ( √ ) ( X ) or ( N/A )
Daily traffic management briefing conducted
‘Permit to Disturb Ground’ issued
‘Authorised Plant Operator’ tabard & key issued
Signature (Miller Construction Issuer)
Daily Permit Closure
‘Authorised Plant Operator’ tabard & key returned
Signature (Plant Operator / Designated ‘Key Holder’ if multi-user)
Signature (Miller Construction Issuer)
Key : √ : No defect X : Defect N/A : Not Applicable to this item of plant
Details of defects, and remedial actions taken to rectify them, should be entered on Page 2
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2. Ref : SOP 3 - PORMP Rev B
Permit to Operate Ride-on Mobile Plant
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Print Name – Operator 2 Print Name – Operator 2 Print Name – Operator 2 Print Name – Operator 2 Print Name – Operator 2 Print Name – Operator 2 Print Name – Operator 2
Plant authorisation is a two stage
process:
1. ‘Initial Authorisation’ - based on Signature – Operator 2 Signature – Operator 2 Signature – Operator 2 Signature – Operator 2 Signature – Operator 2 Signature – Operator 2 Signature – Operator 2
(i) card holding & (ii) demonstration
of plant familiarisation; AND
Print Name – Operator 3 Print Name – Operator 3 Print Name – Operator 3 Print Name – Operator 3 Print Name – Operator 3 Print Name – Operator 3 Print Name – Operator 3
2. ‘Daily Authorisation’ - based on
(i) the Operator / Designated ‘Key
Holder’ completing a daily plant Signature – Operator 3 Signature – Operator 3 Signature – Operator 3 Signature – Operator 3 Signature – Operator 3 Signature – Operator 3 Signature – Operator 3
check & (ii) Miller Construction
providing a Daily Traffic
Management briefing AND issuing Print Name – Operator 4 Print Name – Operator 4 Print Name – Operator 4 Print Name – Operator 4 Print Name – Operator 4 Print Name – Operator 4 Print Name – Operator 4
any appropriate Permit to Disturb
Ground.
Signature – Operator 4 Signature – Operator 4 Signature – Operator 4 Signature – Operator 4 Signature – Operator 4 Signature – Operator 4 Signature – Operator 4
Where there are multi-users of plant
Print Name – Operator 5 Print Name – Operator 5 Print Name – Operator 5 Print Name – Operator 5 Print Name – Operator 5 Print Name – Operator 5 Print Name – Operator 5
ALL plant operators must attend the
traffic management briefing for that
day AND be briefed on the
Signature – Operator 5 Signature – Operator 5 Signature – Operator 5 Signature – Operator 5 Signature – Operator 5 Signature – Operator 5 Signature – Operator 5
requirements of any relevant Permit
to Disturb Ground.
Remedial actions related to defects identified on Page 1:
Multi-users of the item of plant
identified on Page 1 should PRINT
and SIGN their name opposite to
confirm this has taken place.
Operator’s declaration
In signing opposite I confirm that
I have received a traffic
management briefing in relation
to the relevant day and that I have
been briefed on the requirements
of any Permit to Dig applicable to
my work.
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