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Hot Work Permit Form

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Hot Work Permit Form


Requestor details

Company Name of Permit requestor
Contact details of the permit requestor supervisor

Permit Details

Time and Date permit becomes active
Time and Date permit will become deactive

Fire protection on site

Permit issued to
Description of the Hot Work to be undertaken
Sketch of location if required
Fire fighting equipment to be on hand as part of this activity
Fire extinguisher
Sand bucket
Water supply
Fire blanket
Other equipment to be at the ready for this activity

Control Measures

What will be the method for raising the alarm, should a fire break out
Details of raising the alarm
Drains and Pits are covered or isolated
Is the area adequately ventilated
Spark flash screens in place
Area isolated or barricaded off
Fire load reduced, protected or isolated
Fire equipment has been checked, laid out and is fit for purpose.
Will weather conditions potentially effect this task, if so what extra precautions will be enlisted
Other details

Fire watch if required

Details of how the fire watch will be deployed, location, equipment, time post event still required, communication details between hot work and the fire watch person.
Sketch the fire watch location if required.
Fire watch person

Weather conditions if relevant

If weather conditions such as wind or excessive heat will impact on the activity, what precautions will be taken

Completion of Hot Work Inspection

Time and Date post activity inspection undertaken
Details of the post activity inspecton
Name of person undertaking the post activity inspection
Signature of inspecting person

Permit Cancelation

Notes or relevant details if required
Time and Date permit terminated
Staff member terminating this permit
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