Permit to Work - Hot Work v2

• 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.

• Site Location
  Address

• Conducted on

  Date

• Prepared by

• Brief description of job being undertaken

• Has the contractor provided a risk assessment for review that meets the university's requirements?

  Yes

  No

  N/A

Required Precautions Checklist

• Does the work require any fire system isolation's to be put in place, if so what has been isolated?

  Yes

  No

  N/A

• Sprinklers?

  Yes

  No

  N/A

• Smoke Detectors?

  Yes

  No

  N/A

• Heat Detectors?

  Yes

  No

  N/A

• Other?

• Is the Hot Work equipment in safe and good condition?

  Yes

  No

  N/A

• Is an inspected and passed Fire Extinguisher accessible for workers during hot works?

  Yes

  No

  N/A

• Is a First Aid Kit accessible for workers during hot works?

  Yes

  No

  N/A

• Campus Security has been notified of the work taking place on 0800 842 8888 or security@vuw.ac.nz

  Yes

  No

  N/A

• Is a continuous fire watch provided during and for at least 30 minutes after hot work, including all breaks?

  Yes

  No

  N/A

• Fire watch has been trained in the use of fire equipment and sounding alarm?

  Yes

  No

  N/A

Within 10 Meters of the Work

• There are no combustible liquids, vapors, gases or dust within 10 metres of the hot work area?

  Yes

  No

  N/A

• Have all combustible materials been suitably protected against heat and/or sparks?

  Yes

  No

  N/A

• Have all horizontal surfaces (e.g. building structures, equipment, ducts, cable trays, etc.) above and below where possible been cleaned before hot work begins?

  Yes

  No

  N/A

• Have checks been made to ensure all flammable liquids, dust, lint, combustible waste, oil deposits, and the likes have been removed where possible?

  Yes

  No

  N/A

• If removal or cleaning is impractical, have the work area been suitably protected with fire-retardant covers, or shielded with fire-retardant guards and/or curtains?

  Yes

  No

  N/A

• Has any potential heat transmission or conveying of sparks to adjacent areas being checked and eliminated or protected?

  Yes

  No

  N/A

• Have all openings within the 10 metres area been covered with fire-retardant tarpaulins to help protect areas beneath?

  Yes

  No

  N/A

• Have all fans and conveyors been isolated or shut down to prevent the capturing and conveying sparks to other areas?

  Yes

  No

  N/A

• Have checks been made to ensure there is no chance of an explosive atmosphere being present? (use of gas monitors for example in plant room)

  Yes

  No

  N/A

Contractors Details

• Full Name of Person doing the hot work

• Signature of Person doing the hot work

  Sign

• Full Name of the Fire Watch

• Signature of Fire Watch

  Sign

Permit Issuer

• Full Name and Signature of Permit Issuer

• Signature of Permit Issuer

  Sign

• Permit issued date

  Date

• Permit ends date

  Date