-
Hot Work Permit
Part A
-
Permit Reference:
DESCRIPTION OF THE WORK
-
Work Location:
-
Purpose / Type of Work:
-
Permit Expires:
-
Select date
-
Contracting Company:
REQUIRED PRECAUTION CHECKLIST
-
For work likely to produce a source of ignition, including welding, grinding, soldering and the use of spark producing tools or portable equipment, or other determined sources of ignition
-
Are persons entering and working in the hot work area trained and competent
-
Do persons have a current risk assessment for the hot work area and the work to be done
-
Other permits required
Other Permits
-
Permit Type
-
Permit No.
Task Details
-
Task
-
Location
-
Add location
-
Start Date & Time
-
Finish Date & Time
Risk Controls
-
Portable fire extinguisher available
-
Running hose water required
-
Fixed fire suppression systems operational
-
Combustible materials removed from 15 m radius
-
Shielding around combustible materials where clearance is not possible
-
Barricading around job site required
-
Phone or 2-way radio required
-
Area below work area cleared
-
Hot work signs required
-
Interaction with other works considered
Special Conditions
Fire Watch
-
Is a Fire Watch required
Fire Watch
-
Fire Watch name
-
Fire Watch signature
-
Fire Watch Date & Time
-
Is a Post Fire Watch required (min of 30 mins to 2 hours)
Post Fire Watch
-
Post Fire Watch Name
-
Post Fire Watch signature
-
Post Fire Watch START Time & Date
-
Post Fire Watch END Time & Date
Responsible Person
-
I accept this permit, agree to be bound by the conditions above and the associated procedures and accept the responsibility as the person directly in charge of the work in hot work area nominated
-
Responsible Person Name:
-
Acceptor signature
-
Date & Time
Part B
Part B (Permit Issue to complete)
Authorised Person (Permit Issuer)
-
I have inspected the work area where the hot work is to be conducted and satisfied the risk controls are place . I authorise the entry to this hot work area subject to the conditions and risk controls on the risk assessment and as stated on this permit
-
Permit Issuer
- Kim Hall
- Nigel Bullock
- Phil Swass
- Hugo Lugt
- Jan Suldovsky
- Alex Gunn
- Chris Gordon
-
Permit Issuer signature
-
Issue Date & Time
-
Is hot work being conducted in a hazardous area. Hazardous areas include any area that has rubber lined vessels or spirals.<br><br>Additional sign-off by the Project Manager or Site Manager is required
-
Site Manager
-
Site Manager signature
-
Site Manager Date & Time
Transfer
-
Required if Permit Issuer leaves site prior to cancellation of permit. I have inspected the workplace where the hot work is being performed and satisfied the risk controls identified in the risk assessment and this permit are in place
Transfer name
-
Permit Issuer
- Kim Hall
- Nigel Bullock
- Phil Swass
- Hugo Lugt
- Jan Suldovsky
- Alex Gunn
- Chris Gordon
-
Permit Issuer signature
-
Transfer Date & Time:
Part C
Section D
Cancellation (Permit Issuer to complete)
-
All work associated with this permit has been completed. The work area and adjacent areas have been inspected for the duration of fire watch and post fire watch monitoring as stated in this permit. The work area has been cleared of any any debris and equipment is now ready to return to service. This permit is now relinquished.
-
Permit Issuer Name
- Kim Hall
- Nigel Bullock
- Phil Swass
- Hugo Lugt
- Jan Suldovsky
- Alex Gunn
- Chris Gordon
-
Permit Issuer signature
-
Cancellation Time & Date: