Ventia Safety - Hot Work Permit.

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

• Hot work permit No:

• Client / Site

• Maximo Work Order Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

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.<br>I also understand that ONLY the hot work / tasks described on this permit shall be carried out<br>

  Yes

  No

  Not Applicable

• Responsible Person

  Sign

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

  Yes

  No

  Not Applicable

• Safety signs req’d

  Yes

  No

  Not Applicable

• Danger tags req’d

  Yes

  No

  Not Applicable

• Barricading req’d

  Yes

  No

  N/A

• Extra lighting req’d

  Yes

  No

  N/A

• Fire protection req’d

  Yes

  No

  N/A

• Restricted access areas req’d

  Yes

  No

  N/A

• Fall protection req’d

  Yes

  No

  N/A

Special precautions taken / in place

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

  Safe

  At Risk

  N/A

• Exclusion zone set up to control unauthorised entry to work area

  Yes

  No

  Not Applicable

• Trained in the use of the equipment

  Yes

  No

  Not Applicable

• Cutting and welding equipment in good operating condition

  Yes

  No

  Not Applicable

• Electrical equipment tested and tagged by licensed electrician

  Yes

  No

  Not Applicable

• Power sources isolated if working close to live conductors

  Yes

  No

  Not Applicable

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

  Yes

  No

  Not Applicable

• Forced air ventilation in place

  Yes

  No

  Not Applicable

• Equipment cleaned of all combustibles

  Yes

  No

  Not Applicable

• Containers purged of flammable vapours

  Yes

  No

  Not Applicable

• Covers suspended beneath work are to collect sparks

  Yes

  No

  Not Applicable

• All wall and floor openings covered

  Yes

  No

  Not Applicable

• Extinguisher or hose available

  Yes

  No

  Not Applicable

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

  Yes

  No

  Not Applicable

• 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

  Sign

Permitted Persons: I have read this certificate and associated documents and understand the precautions to be taken.

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign