After-Hours Work Procedure & Permit

AFTER-HOURS WORK PROCEDURE & PERMIT

TORONTO DISTRICT
Project # and Name*
Project Number
Subcontractor*
CN_PDF
Date of After-Hours Work*

MonthDayYear
Date
Signee Email
Please enter your email if you wish to receive a copy of the completed form.
During the hours PCL supervision is not present on site, the undersigned agrees to accept the following responsibility and conditions:
- Ensure compliance with the Occupational Health and Safety Act and Regulations and the Project-Specific Safety Plan.
- Designated competent supervisor must be present on site at all times while overtime work is in progress.
- Ensure that at least two (2) crew members are on site at all times and one (1) member has a valid First Aid Certificate.
- All workers, including the Supervisor, must have attended the PCL Project Safety Orientation.
After-Hours Work Permits may not be used:
- For high-risk activities (HRAs).
- When more than one trade contractor is working on site.
- When more than 16 workers are present (PCL project superintendent must review and approve additional workers
Description of Work:*
Projected Hours of Work: *
Special Instructions for Securing the Site:*
Hazard Identification Review:*
Worker with valid First Aid Certificate: First Name Last Name*

Subcontractor Supervisor Name *
Subcontractor Supervisor Signature*
Subcontractor Supervisor Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Security/PCLSubcontractor
Subcontractor Email*
example@example.com
Emergency Contact Info:
Subcontractor Name/Phone (if different from above)
PCL Emergency Contact Name/Phone*
Please use the dropdown list below to select the name of PCL Superintendent and submit form for approval
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Superintendent Name *
PCL Approver Email
example@example.com
Shared Mailbox Email
example@example.com
Shared Mailbox Email (2)
example@example.com
MXHERO
example@example.com
ALL SUBMISSIONS
example@example.com
PCL Superintendent Signature
Should be Empty:

Emergency Contact Info: