Hot Work Permit - KS

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Requestor details

• Company Name of Permit requestor

• Contact details of the permit requestor supervisor

Permit Details

• Time and Date permit becomes active

  Date

• Time and Date permit will become deactive

  Date

• Permit issued to

  Sign

• Description of the Hot Work to be undertaken

• Sketch of location if required

  Drawing

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

• Fire extinguisher

  Yes

  No

  N/A

• Sand bucket

  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

Control Measures

• What will be the method for raising the alarm, should a fire break out

• Details of raising the alarm

• Drains and Pits are covered or isolated

  Yes

  No

  N/A

• Is the area adequately ventilated

  Yes

  No

  N/A

• Spark flash screens in place

  Yes

  No

  N/A

• Area isolated or barricaded off

  Yes

  No

  N/A

• Fire load reduced, protected or isolated

  Yes

  No

  N/A

• Fire equipment has been checked, laid out and is fit for purpose.

  Yes

  No

  N/A

• Will weather conditions potentially effect this task, if so what extra precautions will be enlisted

  Yes

  No

  N/A

• Other details

Fire watch if required

• Details of how the fire watch will be deployed, location, equipment, time post event still required, communication details between hot work and the fire watch person.

• Sketch the fire watch location if required.

  Drawing

• Fire watch person

  Sign

Weather conditions if relevant

• If weather conditions such as wind or excessive heat will impact on the activity, what precautions will be taken

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

Permit Cancelation

• Notes or relevant details if required

• Time and Date permit terminated

  Date

• Staff member terminating this permit

  Sign