Information

  • Contract (Ask supervisor for name of contract)

  • Prepared by

  • Conducted on

  • Location
  • Personnel

Requestor details

  • Company Name of Permit requestor - (IAS)

  • Contact details of the permit requestor supervisor

Permit Details

  • Time and Date permit becomes active

  • Time and Date permit will become deactive

  • Contact details of person granting permit

  • Signature of representative granting permit

  • Permit issued to

  • Description of the Hot Work to be undertaken

  • Sketch of location if required

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

  • Fire extinguisher

  • Sand bucket

  • Water supply

  • Fire blanket

  • 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

  • Is the area adequately ventilated

  • Spark flash screens in place

  • Area isolated or barricaded off

  • Fire load reduced, protected or isolated

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

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

  • 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.

  • Fire watch person

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

  • Details of the post activity inspecton

  • Name of person undertaking the post activity inspection

  • Signature of inspecting person

Permit Cancelation

  • Notes or relevant details if required

  • Time and Date permit terminated

  • Staff member terminating this permit

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.