QSHE 183b Hot work Permit

• Site conducted

  Select

• Date the task is taking place? (Permit is valid for 24hrs)

  Date

• Prepared by

• Location
  Address

• What is the task? (Brief description of the work taking place).

• What is the name of the contractor?

• Is the contractor performing the task approved on the suppliers database

  Yes

  No

• Address issue with purchasing department

  Select Issue addressed with purchasing dept

  • Issue addressed with purchasing dept

• Name of the site workgroup manager/supervisor?

• What is the site workgroup manager/supervisors telephone number?

• All members of the workgroup site inducted?

  Yes

  No

• Perform QSHE 121b Contractor Induction and retain evidence.

  Complete

• Is the worker(s) Gas Safe or similar qualified? Have all related licences/skills cards been witnessed, in date and evidence taken?

  Yes

  No

• What evidence do they have to show they are competent to perform the task?

• Risk Assessment/Method Statement received and approved?

  Yes

  No

• Review risk assessment and ensure all precautions stated are in place before work commences.

  Select Confirmed adherence to the rule

  • Confirmed adherence to the rule

• Has a cooling off period been factored into the risk assessment

  Yes

  No

• Cooling off period stated in the risk assessment.

• A cooling off period must be adhered to at the end of the work day/task. This is to allow equipment and work/process materials to cool. Any items smoldering can also be detected and extinguished . The during of the cooling off period will be featured within the risk assessment provided by the supplier. Return the risk assessment back to the supplier for revision if this feature is missing.

  Confirm requirement.

Significant Hazards and Control Measures . (See Risk Assessment and Method Statement for full details)

• Type of hot work

  Select Blow lamps Brazing Cutting Grinding Soldering Welding Other Sources of heat generation

  • Blow lamps
  • Brazing
  • Cutting
  • Grinding
  • Soldering
  • Welding
  • Other Sources of heat generation

• Hazards

  Select Arc Eye/Welders Flash Explosive potential of work Fire in immediate area + Spread Potential Lone Working Other (Please detail)

  • Arc Eye/Welders Flash
  • Explosive potential of work
  • Fire in immediate area + Spread Potential
  • Lone Working
  • Other (Please detail)

• Precautions

  Select Area damp down needed? Cooling off period? (Approx 30mins after task) Trained fire watchers Correct fire extinguishers Caution notices/Barriers Additional PPE to be worn Other (Please detail)

  • Area damp down needed?
  • Cooling off period? (Approx 30mins after task)
  • Trained fire watchers
  • Correct fire extinguishers
  • Caution notices/Barriers
  • Additional PPE to be worn
  • Other (Please detail)

• Are you using any electrical extension leads?

  Yes

  No

• If using extension leads, you MUST not overload any units, have extensions fed from extensions (Daisy Chaining) and any cabling on spools must be fully wound out to prevent overheating.

  Select Confirmed adherence to the rule

  • Confirmed adherence to the rule

• Does the task involve working at height or with electrics?

  Yes

  No

• You must complete additional permits (183a Electrical / 183c Working at Height)

  Complete

• Do you require any PPE in addition to site minimum of Hi Viz and Safety Footwear?

  Yes

  No

• List additional PPE required (As detailed in your Risk Assessment/Method Statement)

What are your First Aid Arrangements

• Who is to assist you in the event of a First Aid Incident

  Schenker's First Aiders

  Own First Aider

• Have the First Aid team been made aware of your work on site?

  Yes

  No

• First aid team notified

  Confirm requirement.

Emergency Preparedness

• In the event of a fire, is extinguisher/chemical run off into water courses/drains a possibility?

  Yes

  No

• Emergency spill kit and trained staff needed

  Confirm requirement.

Waste Disposal

• Are you generating wastes as part of your task?

  Yes

  No

• How are you disposing of the waste?

  Select Schenker's waste arrangement (Segregation required) Own arrangement (Advise waste carrier's name)

  • Schenker's waste arrangement (Segregation required)
  • Own arrangement (Advise waste carrier's name)

• Name of waste carrier arranged to collect waste

Authorisation and Acceptance for task to commence

• On behalf of Schenker Ltd, I authorise the work to be undertaken having personally examined the work site and all the documentation and confirm the precautions taken are adequate and conform to DB Schenker's QSHE Policy

• Issued by :

• Authorised Signature

  Sign

• On behalf of Contractor Supervisor/Manager, I have personally examined the work location and have read and understood this from.
  I undertake to ensure that all works are carried out in accordance with this permit and my own Risk Assessment and Method Statement.

• Issued To:

• Authorised Signature

  Sign
End of Day. Worksite safe handover declaration

• Has a cooling off period at the end of the day been fulfilled?

  Yes

  No

• A cooling off period in accordance with the provided risk assessment must be adhered to at the end of the work day/task.

• Work progressing to satisfaction, as per the job order. All work materials, wastes and equipment have been removed (Or made safe). Site services have been restored (if work complete). The area is safe to recommence normal working activities.

  Yes

  No

• State issues.

• Confirmed by Contractor

• Authorised Signature

  Sign

• Witnessed by (Schenker)

• Authorised Signature

  Sign

• Date and Time of sign off

  Date

• Any final remarks/Comments?

  Yes

  No

• Your remarks

Job Completion Declaration

• Task complete?

  Yes

  No

• Return to End of day worksite safe handover declaration section.

• Has a cooling off period at the end of the day/job been fulfilled?

  Yes

  No

• A cooling off period in accordance with the provided risk assessment must be adhered to at the end of the work day/task.

• Work progressing or Work completed to satisfaction, as per the job order. All work materials, wastes and equipment have been removed (Or made safe). Site services have been restored (if work complete). The area is safe to recommence normal working activities.

• Confirmed by Contractor

• Authorised Signature

  Sign

• Witnessed by (Schenker)

• Authorised Signature

  Sign

• Date and Time of sign off

  Date

• Any final remarks/Comments?

  Yes

  No

• Your remarks