Checklist

The version control will be maintained by the SHEQ team and is controlled via the Safety Equipment Inspections Document 2073838157-15.
Description of works

PERMIT HOLDER: I have read this certificate and understand the precautions to be taken. I will explain these precautions to all people working with me on this job and will obtain their signature(s) prior to work commencing.
I also understand that ONLY the hot work / tasks described on this permit shall be carried out

Responsible Person
Special precautions required to be taken
To be completed by the person carrying out the task(s) in identifying the necessary requirements as listed below.

Isolations req’d

Safety signs req’d

Danger tags req’d

Barricading req’d

Extra lighting req’d

Fire protection req’d

Restricted access areas req’d

Fall protection req’d

Special precautions taken / in place

Specify details of work to be conducted. Is it cutting, welding, heating, grinding other

Exclusion zone set up to control unauthorised entry to work area

Trained in the use of the equipment

Cutting and welding equipment in good operating condition

Electrical equipment tested and tagged by licensed electrician

Power sources isolated if working close to live conductors

Work area clear of combustible material OR
(a) Combustible or flammable liquids adequately covered or shielded from heat / sparks
(b) Combustible floors / surfaces wet down or adequately covered from heat / sparks

Forced air ventilation in place

Equipment cleaned of all combustibles

Containers purged of flammable vapours

Covers suspended beneath work are to collect sparks

All wall and floor openings covered

Extinguisher or hose available

The area has been monitored for the lower explosive limit (LEL) of the atmosphere

The location has been inspected and necessary precautions identified and permission granted only for the work specified on this permit Workers and/or work groups in the vicinity of the hot works have been consulted prior to works commencing
Permitted Persons: I have read this certificate and associated documents and understand the precautions to be taken.
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