Hot Work Permit
  Name
Location of work  
Date  
  Valid from
Valid Until  
Job Start Time  
Completion Time  
  Work Description
     
  Find / Remove Flammable Hazards Where Possible
  • Flammable Liquids
  Yes   No
  • Flammable Gas
  Yes   No
  • Flammable Solids
  Yes   No
  • Coating (paints, rubber etc)
  Yes   No
  • Services (electrical, hydraulics etc)
  Yes   No
  • Other (Specify)
  Has the Fuel Source been Made Sage By
  •   Wetting Down Work
  Yes   No
  •   Providing Fire Blankets or Screens
  Yes   No
  •   Isolating
  Yes   No
  •   Blanking Lines
  Yes   No
  •   Disconnecting
  Yes   No
  •   Closing Valves
  Yes   No
  •   Is the work area free of gas?
  Yes   No
  •   Other (Specify)
 
  Combustible and/or Toxic Gas Test
  Carried out By
  Date   Time
  Sign
 
  Required Safety Equipment
  (1)   (2)
  (3)   (4)
  (5)   (6)
 
  Authorisation for Hot Work Task
  The area described above and surrounding conditions are in
  my opinion, safe for the work specified on this permit,
  provided that the precautions above are adhered too.
 
  Supervisor/Manager  
  Signature Sign
  Date   Time
  Precautions for Area
  • Sewers, Drains and Trenches within 20 meters sealed
  • Fire Guard Provided
  • Fire Protection available-Extinguishers, Hoses etc.
  • Welding or Electrical Equipment Correctly Sited
  • Earthing and bonding correctly applied
  • Vent Provided if Required
  • Safety Signs Installed
  • Breathing Apparatus provided, if required
  
  Personal Protective Equipment
  • Ensure all appropriate protective/safety equipment is worn
  
  General
  • Wind Direction has been Considered
  • Electrical Equipment Disconnected/Looked Out/Properly
      Tagged
  
  Tank/Vassel/Container
  • Tank/Vessel etc Safe for Hot work
  • Sludge/Residue in the Tank that could Release
      Combustible or Toxic Vapours
  
  Equipment to be used
  • Arc Welding
  • Oxy Welding
  • Flame Cutting
  • Electric Drill
  • Grinder
  • Others
  
  Fire Watecher (Weldores shall not work alone AS167.1-3.7 D& E)
  Fire Watchers Name
  
  Employee/Contractor to Perform Hot Work
  I understand the safely procedures required for the ablove
  mentioned hot work taxk, the safely equipment to be used and a
  working knowledge for the equipment to be used
  
  Employee Name  
  Employee/ Contractor Signature sign
  Date   Time