Title Page
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This Hot Work Permit is required for any operation involving open flames or producing heat and/or sparks. This includes, but is not limited to, Brazing, Cutting, Grinding, Soldering, Thawing Pipe, Torch-Applied Roofing, and Welding.
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Permit No.
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Site Location
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Conducted on
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Prepared by
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Name of fire watch person
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Nature of Job/Object
Required Precautions Checklist
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Are water hoses or fire extingishers available and in good repair?
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Hot Work equipment in good repair.
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Have flammable liquids, dust, lint and oily deposits within 35 ft. been removed?
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Have explosive atmosphere been eliminated? Test results:
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Has the work surface been cleaned of grease, paint, etc?
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Have combustible floors been wet down, covered with damp sand or covered with fire resistant sheets?
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Have surface areas below work area been protected?
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Have access ways below work area been barricaded?
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Are UV shields in place?
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Has enclosed equipment been cleansed of all combustibles?
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Have all containers been purged of flammable liquids and vapours?
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Will fire watch be provided during and for 60 minutes after work, including coffe and/or lunch breaks?
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Has fire watch been provided with suitable fire extinguishing devices?
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Has the fire watch person been trained in use of fire extinguishing devices and in sounding alarm(s) or other emergency communications?
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Has additional fire watch been assigned to adjoining areas, above and below?
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Hot work area will be monitored for 4 hours after completion of work?
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Other:
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Other:
Completion
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Full Name and Signature of Permit-Authorizing Personnel
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Click + to add names of persons doing the hot work
Employee
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Full Name and Signature of Person doing the hot work
