Hot Work Permit

• Document Number

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Hot work is being performed by

  Select

• Date and start time

  Date

• Nature of Jobs

  Select

• Name of person(s) doing Hot Work

• Signature of person applying for Hot Work Permit

  Sign

Precautions Checklist

• Available hose streams, and/or 20lbs. Fire extinguisher are in service

  Yes

  No

  N/A

• Hot work equipment in good repair

  Yes

  No

  N/A

Requirements within 25 feet of work

• Flammable liquids, dust, lint and oil deposits removed

  Yes

  No

  N/A

• Explosive atmosphere in the area removed.

  Yes

  No

  N/A

• Floors swept clean.

  Yes

  No

  N/A

• Combustible floors wet down, covered with damp sand or fire resistant sheets.

  Yes

  No

  N/A

• Remove other combustibles where possible. otherwise protected with fire blankets or metal shields

  Yes

  No

  N/A

• All wall and floor opening covered.

  Yes

  No

  N/A

• Fire blankets suspended beneath work.

  Yes

  No

  N/A

Work on wall and floor openings covered.

• Construction is noncombustible and without combustible coverin or insulation.

  Yes

  No

  N/A

• combustibles on the other side of walls moved away.

  Yes

  No

  N/A

• Enclosed equipment cleaned of all combustibles

  Yes

  No

  N/A

• Containers purged of flammable liquids/vapors.

  Yes

  No

  N/A

Fire watch/ hot work area monitoring

• Fire watch personnel will be provided during and for 30 minutes after work (including any coffee or lunch breaks).

  Yes

  No

  N/A

• Fire watch personnel are supplied with suitable extinguisher.

  Yes

  No

  N/A

• Fire watch personnel are trained in use of this equipment and in sounding alarm.

  Yes

  No

  N/A

• Fire watch personnel are/may be required for adjoining areas above and below

  Yes

  No

  N/A

• Monitor hot work area for 30 minutes after job is complete

  Yes

  No

  N/A

other precautions taken

• Confined entry permit?

  Yes

  No

  N/A

• Area protected with smoke or heat detection?

  Yes

  No

  N/A

• Ample ventilation to remove smoke/vapor from work area.

  Yes

  No

  N/A

• Lockout / Tagout / Try out locks required?

  Yes

  No

  N/A

I Verify the above location has been examined, the precautions checked to prevent fire, and permission is authorized for work.

• Signed

  Sign

• Permit Expires (24 hours from star)

  Date

Cancellation:

• I verify the hot works job as outlined on this permit has been completed, all requirement have been met, and termination of the permit is requested

  Sign

THIS PERMIT IS VALID FOR ONE SHIFT ONLY