Title Page
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Site Location
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Person carrying out hot works
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Subcontractor
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Date issued
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Time issued
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Exact location of hot works
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For high risk activities, this permit is valid for one day only.
The following work permit must be completed and issued to the hot work performer/s prior to carrying out any type of hot works. This permit will remain 'live until signed off by the Arrow Site Manager. -
Brief description of works being carried out
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PRE ISSUE RISK ASSESSMENT: ANSWER THE FOLLOWING QUESTIONS BEFORE ISSUING THIS PERMIT.
NOTE, EACH ITEM MUST BE DISCUSSED WITH THE HOT WORKS PERFORMER/S -
Has the person in charge of hot works read and understood the requirements of their safe method of work (e.g. TA, JSA or SWMS) along with that of any other co worker?
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Are all areas within 5 metres of hot work clean and free of all hazardous and combustible materials?
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Hot work for elevated work – if yes, remove combustibles 15 metres from hot works location and site.
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If the above removal of combustibles is not possible, is the area controlled by wetting down floors, suspending covers beneath works to collect sparks, covering wall and floor coverings with fire resistant blanket or similar where welding, cutting or grinding the work either is suitably screened?
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Have opposite sides of walls, partitions and ceilings been cleared of combustible materials if risk of fire by conducted heat is present?
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If the area has been assessed as extremely high risk, has a dedicated non-working fire watch person been arranged to monitor the areas whilst work is in progress?
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If smoke alarms require temporary disconnection, as 24 hour notice been given to the client or building occupier and a continuous non-working fire watch person been provided?
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Is the owner of the hot work permit trained in fire extinguisher use and is the correct selection of fire extinguisher within close proximity of works?
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DO NOT ISSUE THIS PERMIT IF YOU HAVE ANSWERED ‘NO’ TO ANY OF THE ABOVE QUESTIONS
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Confirmation that the above items and controls have been discussed with the person/s taking ownership of the permit
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Arrow Issuer (Name and Signature)
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Hot Work Performer Confirmation
I confirm that I have discussed and agreed with those involved in the above items and controls -
Contractor Receiver (Name and Signature)
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Contractor Receiver (Name and Signature)
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Contractor Receiver (Name and Signature)
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Contractor Receiver (Name and Signature)
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Contractor Receiver (Name and Signature)
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Hot Work Completion Checks
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Task is completed and work area has been tidied and left in a safe condition.
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30 and/or 60 minute fire checks completed by hot work performer or dedicated non-working fire watch.
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Smoke alarms have been reconnected and read for use by competent person.
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Hot work area/s have been inspected by Arrow site management following completion of high risk works.
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DO NOT SIGN OFF THIS PERMIT IF YOU HAVE ANSWERED ‘NO’ TO ANY OF THE ABOVE QUESTIONS
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Permit close out: All hot work areas have been left in a safe and secure manner.
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Subcontractor (Name and Signature)
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Date
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Time
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Arrow (Name and Signature)
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Date
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Time
