Hot works Permit - VPP001

• Loaction of Site
  Address

• Conducted on

  Date

• Prepared By

• Work description

• Type of work

  Select Flame cutting Welding Hot cuttign (with abrasive wheel)

  • Flame cutting
  • Welding
  • Hot cuttign (with abrasive wheel)

• Person Undertaking work

• Is the person compitent?

  Select Yes No

  • Yes
  • No

• Contact Details

• Permit Valid From

  Date

• Permit Valid To

  Date

Hazards & Control Measures

• Potential hazards

  Select Oxygen enrichment Oxygen depletion Toxic Gas Explosive Gas Bio Hazard Enviromrental Hazard Poor Lighting Heat Noise Fire

  • Oxygen enrichment
  • Oxygen depletion
  • Toxic Gas
  • Explosive Gas
  • Bio Hazard
  • Enviromrental Hazard
  • Poor Lighting
  • Heat
  • Noise
  • Fire

• Control Measures

  Select Hazard/Equipment Isolated Watchman Fire extinguishers Fire Blanket Protective equipment Department Staff Informed

  • Hazard/Equipment Isolated
  • Watchman
  • Fire extinguishers
  • Fire Blanket
  • Protective equipment
  • Department Staff Informed

• Other Hazards Identified

• Control Measures

Safety Requirments

• All areas to be checked and combustibles removed or protected before commencement of work

  Yes

  No

• All areas to be Screened, Protected, roped off where necessary and warning signs displayed

  Yes

  No

• All systems associated with the work to be isolated, inclusive of smoke alarms

  Yes

  No

• Assistant to standby with fire extinguisher suitable for task. (Competent in use)

  Yes

  No

• Building Facilities Manager notified

  Yes

  No

• Area to be checked/inspected for combustion 30 mins after completion of work

  Yes

  No

Personell entering the work area

• Person 1

• Signature

  Sign

• Person 2

• Signature

  Sign

• Person 3

• Signature

  Sign

• Person 4

• Signature

  Sign

Permit validation

• Permit issued By

• Date and time

  Date

• Signature

  Sign

• Permit received By

• Date and time

  Date

• Signature

  Sign