Polini Diversified Services Pty Ltd - Hot Work Post-Notification

• Hot Works Pre-notification Reference (DDMMYYYY - Site):

• Client

• Conducted on

  Date

• Prepared by

After completion of works

• Has the work site been cleared of all debris and contaminated material removed?

  Yes

  No

  N/A

• Has the fire watch been in place for a period of one hour from completion of activities?

  Yes

  No

  N/A

• HaHas an inspection been made of the work area and surrounding equipment and deemed to be safe with NO risk present?

  Yes

  No

  N/A

• Have all blanking plates or fire blankets been removed?

  Yes

  No

  N/A

• Have all isolations been removed?

  Yes

  No

  N/A

• Signature

  Sign