Hot Works Permit HSE-s-013

• Property Address
  Address

Permit Details

• Date & Time Permit becomes active

  Date

• Date & Time Permit will become deactive

  Date

• Company name requesting permit

• Permit Requester

• Permit issued to

• Description of Hot-works to be undertaken

Precautions to be taken before works.

• All combustible materials and flammable substances to be removed where practicable?

  Yes

  No

  N/A

• Plant stores, wooden flooring and other combustible materials to be protected from sparks, hot material & damage?

  Yes

  No

  N/A

• Have the effects of heat transfer through any openings and cracks in the building fabric or along metallic pipe work been assessed and suitable precautions taken, e.g lagging on hidden pipe work in ceilings or voids removed for a safe distance or heat resistant mat/sprays utilised?

  Yes

  No

  N/A

• Is hot work equipment in good state of repair?

  Yes

  No

  N/A

• Correct clothing to be worn and in good condition?

  Yes

  No

  N/A

• Are tar boilers & other similar equipment to be taken on roof?

  Yes

  No

  N/A

• IF YES IS A SPECIFIC RISK ASSESSMENT IN PLACE?

  Yes

  No

  N/A

• List other precautions to be taken

Precautions during work

• Correct fire fighting equipment to be kept in close proximity to area of work until permit is cancelled

  Yes

  No

  N/A

• LPG / HFL cylinders to be secured in vertical position (Apart from Hand Held 500g cylinders)

  Yes

  No

  N/A

• Fittings and hoses in good condition, fitted with regulators & flashback arrestor

  Yes

  No

  N/A

• Empty cylinders / bottles to be removed from work area to secure compound , or off site

  Yes

  No

  N/A

• When welding, cutting & grinding the work area to be screened with non-combustible material

  Yes

  No

  N/A

• List other precautions to be taken

Post Work Operation

• 30 minutes after completion of works a fire check must be conducted

  Yes

  No

  N/A

Authorisations

• All signatories to this permit confirm that they understand the precautions to be taken prior and during work. The recipient of this permit is responsible for the safety of all persons and equipment involved. Only the authorised Person can cancel this permit.

• Permit issued by (Authorised Person

• Signed

  Sign

• Recipient of Permit

• Signed

  Sign

• Surrendered by

• Signed

  Sign

• Cancelled by (Authorised Person)

• Signed

  Sign

• Date and time of surrender

  Date