McPherson - Hot Work Permit 1.0

• Hot Work Permit Number

• Date of Hot Work.

  Date

• Time Hot Work Begins.

  Date

• Time Expires.

  Date

• Time Hot Work Ended.

  Date

• Project Name (Jobsite)

• Location
  Address

• Company Performing Work

• Job Number

• Craft/Mechanic Performing Hot Work

• Purpose of Hot Work?

Hot Work Questions

• Curtains in place preventing inadvertent exposure to nearby workers?

  Yes

  No

• Flammable and combustible liquids been removed from the area?

  Yes

  No

• Fire extinguishers placed in immediate reach of workers in the area of Hot Work?

  Yes

  No

• Combustibles move form the area to prevent fire?

  Yes

  No

• Floor swept clean in the area of the Hot Work?

  Yes

  No

• Welding blankets covering combustibles which can not be moved in the Hot Work/Room area?

  Yes

  No

• Fire alarm system in service?

  Yes

  No

• Welding/Cutting equipment has been inspected and found to be safe?

  Yes

  No

• Respiratory protection required or needed?

  Yes

  No

• Fire sprinkler system in service?

  Yes

  No

• Is fire watch required due to limited occupancy in the area where Hot Work is performed?

  Yes

  No

Fire Watch

• Reason for Fire Watch?

• Please type the closest fire exit.

• Fire Watch name, #1?

• Assisting Employee

• Fire Watch name, #2?

• Assisting Employee

• Print and signed by Mcpherson job site supervisor.

  Sign