Hot Work Permit

• Site conducted

  Select

Section 1 - Risk Assessment

• A hard copy of this form (FM: WE028) is also available on the Shared Drive.

• No hot work is to be carried out during total fire ban days. During fire danger season you must ensure all regulations are followed (such as adequate clearance, easily accessible water source, fire extinguisher within reach and a suitable action plan, in the unlikely event that an incident occurs).
  
  Monitor Country Fire Service (CFS) (https://www.cfs.sa.gov.au/site/bans_and_ratings.jsp) or Bureau of Meteorology (BOM) (www.bom.gov.au) websites for current fire danger risk, fire ban’s and ratings for the appropriate regions where works is being carried out.
  
  No works are to be carried out in regional areas, areas outside the metropolitan area or areas where dry grasses and vegetation exist without the approval of the General Manager, Operations prior to commencement.
  
  If you are unsure, contact the Country Fire Service (CFS) for further information on 1300 362 361.

• Is it a Fire Ban Day?

  Yes

  No

• Do NOT proceed, no hot works can take place during a Fire Ban Day.

• Date:

  Date

• Site Name:

• Location of hot work:
  Address

• Fire Ban District - if unsure, please see your Supervisor/Manager.

  Select Adelaide Metropolitan Mount Lofty Ranges Kangaroo Island Mid North Yorke Peninsula Murraylands Riverland Upper South East Lower South East Flinders North East Pastoral Eastern Eyre Peninsula North West Pastoral Lower Eyre Peninsula West Coast

  • Adelaide Metropolitan
  • Mount Lofty Ranges
  • Kangaroo Island
  • Mid North
  • Yorke Peninsula
  • Murraylands
  • Riverland
  • Upper South East
  • Lower South East
  • Flinders
  • North East Pastoral
  • Eastern Eyre Peninsula
  • North West Pastoral
  • Lower Eyre Peninsula
  • West Coast

• Description of hot work:

• Likely ignition source type(s):

  Select Flame (welding, soldering, brazing etc.) Spark or slag (grinding, cutting, friction tools, welding etc.) Hot object (metal surface, plate etc.) Other:

  • Flame (welding, soldering, brazing etc.)
  • Spark or slag (grinding, cutting, friction tools, welding etc.)
  • Hot object (metal surface, plate etc.)
  • Other:

• Please list:

• Document the hazards and analyse the risks associated with the hot work activities to be undertaken.

• Hazard - list the hazards relating to the work:

• Controls - list the controls to manage each of the hazards:

• Responsible Party - list the role, contractor, competency &/or prescribed occupation responsible for implementing the controls:

• Risk Assessment - with controls in place, L-1, L-2, M-3, M-4, H-5, H-6 (please refer to the JSEA - Hazard Control Hierarchy):

• Identify those general hot work and ignition controls required to be undertaken as part of the hot work (identify as yes or not applicable). Please ensure each item is considered carefully.

• Fire extinguisher(s) available or water source (i.e. knapsack etc.) and located immediately adjacent to the hot work area and within 10m (building/fixed location fire extinguishers are not to be relied upon).

  Yes

  N/A

• Combustible and flammable materials or fuel sources are required to be cleared from the area.

  Yes

  N/A

• Combustible floors wet down, adjacent areas outside wet down, grasses/vegetation wet down thoroughly (if cannot be removed), covered with sand, metal or other shields.

  Yes

  N/A

• Drains, cable racks, electrical cables, wall and floor openings and other heat/fire sensitive items are to be covered.

  Yes

  N/A

• A water hose is to be run to the job location and primed ready for use (where appropriate for work locations outdoors and in areas clear of electrical equipment).

  Yes

  N/A

• Fire retardant drapes suspended beneath or around the works to collect/contain sparks or slag.

  Yes

  N/A

• The work area will require pre-work cleaning, purging, ventilating or pre-work atmospheric monitoring (due to flammable/explosive vapors, dusts, liquids or solid residues in the work area).

  Yes

  N/A

• The nature of the work requires specific respiratory protection to be worn.

  Yes

  N/A

• A fire watcher is required to watch the area during and 30 minutes post operation to monitor fire risk, sparks, slag, hot objects (consider for work in hazardous areas, confined spaces, outdoors, in windy conditions etc.).

  Yes

  N/A

• No hot work permits are to be issued less than two hours before vacating the premises.
  
  This acknowledgement signifies a formal request to commence hot works. As the person requesting this permit, I hereby certify that:
  • I am competent to coordinate this hot work in accordance with the Risk Assessment and Hot Work Permit details (refer to Section 1-3);
  • I shall undertake to implement all planned and necessary controls to ensure safe hot work methods; and
  • I shall monitor the hot work hazards and control methods throughout the hot work.

• Completed by (include Position Title):

  Sign

AG Security Authorisation

• To be signed/completed by the person who is responsible for authorising hot work.

• Completed by (include Position Title):

  Sign

• Permit expiry:

  Date

• Time started:

  Date

• Time completed:

  Date

Final Check-up

• To be signed by the person who supervised hot work (fire watcher).
  
  This acknowledgement signifies that the work area and all adjacent areas where sparks might have spread were inspected 30 minutes after the work and no fire conditions were noted.

• Completed by (include Position Title):

  Sign

• If you have completed this form, please select 'Submit' to notify the WHS Advisor. Any actions will need to be managed by you and or the appropriate person(s).

  Submit