Energized Electrical Work Permit (EEWP)

Energized Electrical Work Permit (EEWP)
Purpose

This permit authorizes energized electrical work only when de-energization is infeasible or introduces great hazard.

Energized work is the exception — not the norm.
Job Identification
Site
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please use 24-hour time
Work Order #
Equipment ID/Panel ID
Justification
De-energization is not feasible because (check all that apply):

Other
Detailed Explanation
Hazard Analysis
Nominal Voltage
Shock Boundary
Available Fault Current (if known)
Arc Flash Boundary
Incident Energy at Working Distance
Required PPE Category
Approach restrictions established?
Barricades installed?
Exclusion zone established?
Control Verification
Authorization
Electrical Authority Name

First NameLast Name
Electrical Authority Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Superintendent

First NameLast Name
Superintendent Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Permit Expiration Time (maximum length: 1 shift)

Please use 24-hour time
Should be Empty:

Job Identification