Permit to Operate in Urgent Cases - Beyond 180 Days with Action Plan

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This application should be completed by companies who require coverage for more than 31 calendar days

Please ensure that this application is complete and submitted to TSASK with the appropriate fee at least 14 days prior to start date.

Company Information

Company Address

Company Phone

Authority for Application
The information provided in this section will be used to verify the application was submitted on the applicant's behalf.

Phone Number


Being in a position of authority and having knowledge of the plant's operation and equipment, I declare the applicant has a valid Power Engineering Licence, is trained and has intimate knowledge and experience with the specific equipment and operating procedures of the plant. Thus, at a higher level, has the capacity to safely be in charge of the boiler(s), control system, machinery, equipment and safety procedures at the plant mentioned. I recognize that a Permit to Operate in Urgent Cases is a Temporary measure and the above mentioned company is committed to achieving the Legislated staffing requirements by recruiting or through a commitment to the training and support of the power engineer in achieving his/her certification. I recognize that this commitment shall be honestly made and efforts will be made to be permit free as early as reasonably possible.

Power Engineer
Full Name

Please indicate the current classification in which the above mentioned Power Engineer is presently operating, from the drop-down below

Please indicate the higher level position for which a permit is being requested, from the drop-down below

Plant Location

Boiler 1 Information

Boiler 2 Information

Boiler 3 Information

Permit Information
Start Date

Payment Information

Total Amount: $1,298.00

Payment Method
Credit Card Information

Billing Information