GCC Hot Work Permit

• Project Name

• Project Number

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Requestor details

• What is the name of the Company requesting the permit?

• What is the name of the person doing the hot work?

• What is the name of the person on fire watch?

• Fire watch is required for a minimum of 30 minutes after hot work is completed.

Permit Details

• What is the time and date permit becomes active?

  Date

• What is the time and date the permit expires?

  Date

• What is the exact location of the hot work?

• Give a description of the hot work task being performed.

• What is the name of person approving the Permit?

• Contractor's Supervisor Signature

  Sign

• GCC Supervisor Signature

  Sign

• Fire fighting equipment to be on hand as part of this activity

• Fire extinguisher

  Yes

  No

  N/A

• Water supply

  Yes

  No

  N/A

• Fire blanket

  Yes

  No

  N/A

• Other equipment to be at the ready for this activity

Precautions

• Have the flammable liquids, dust, lint and oil deposits been removed from the area?

  Yes

  No

  N/A

• Has any explosive atmosphere been eliminated?

  Yes

  No

  N/A

• Give details if necessary.

• Have the floors been swept and/or mopped?

  Yes

  No

  N/A

• Are the floors of a combustible material, if so were they wet down with water or covered with fire resistant tarpaulins?

  Yes

  No

  N/A

• Are all wall and floor openings covered?

  Yes

  No

  N/A

• Has enclosed equipment been cleaned of all combustibles?

  Yes

  No

  N/A

• Is there ample ventilation for the work area?

  Yes

  No

  N/A

• Is lockout/tag out required?

  Yes

  No

  N/A

• Give details if necessary.

Completion of Hot Work Inspection

• Time and Date post activity inspection undertaken

  Date

• Details of the post activity inspecton

• Name of person undertaking the post activity inspection

• Signature of inspecting person

  Sign