Information
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Document No.
Work Details (Completed by Employees in charge of work)
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Date of Issue:
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Time:
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Site/Depot:
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Work location:
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Name of person issuing permit:
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Person in charge of Hot Work:
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Description of Hot Work:
Precautions (Completed by person in charge of work)
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General Area (The following criteria must be met within 10 meters of the hot work area)
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Floor clear of combustibles<br>
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Combustible floors wet down or covered
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Area clear of flammable materials including gas, liquid and dust
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Wall or floor openings covered<br>
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Area beneath work protected from flames, sparks and molten material
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Wind from open doors, windows, fans and air conditioners eliminated<br>
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Relevant services isolated (e.g. electricity, gas, water, air and hydraulic)<br>
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Work on walls, floors and ceilings
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Verify walls, floor, ceiling and insulation is not combustible
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Equipment
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Flash-back arrestors fitted to welding equipment
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Welding equipment earthed as close as possible to object being welded
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Electrical equipment in good order with current inspection & test tag attached
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Power leads stowed away and not subject to damage
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Appropriate PPE available
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Fire Fighting
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Appropriate fire extinguisher and/or hose reel available in immediate work area
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Work area observed for 30 minutes after completion
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Qualifications & Training
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Persons conducting the hot work are suitably qualified and experienced
Authorisation (Completed by Permit Issuer)
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Permit Validity: The duration of the hot work permit must not exceed more than one (1) day, after which a new permit must be issued
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From Date and To Date:
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From Time and To Time:
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Name of Permit Issuer:
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Signature of Permit Issuer:
Commencement (Completed by persons performing the hot work)
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Sign-on upon commencement of work
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Date:
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Time:
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Sign-off upon completion of work
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Add signature
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Date:
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Time:
Completion (Completed by Permit Issuer)
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Name:
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