Hot Work permit format
September 1st, 2010
Here is a hot work permit format, and some hot work management tips, courtesy of SRT.
Keep Hot Work permit formats, permits in use, and used permits, at work sites.
Use a separate permit for each job and each work area.
Tailor permits to list relevant jobs and relevant hazards.
I (name and job title) ,,,,
am required to carry out hot work,
and request a permit from the competent or responsible person,
to access the plant or apparatus or area.
Work site ,,,,
Building ,,,,
Plant or equipment ,,,,
Permit Number ,,,,
Persons involved by job title and name
1 ,,,,
2 ,,,,
3 ,,,,
Start date and time ,,,,
End date and time ,,,,
Ignition source
[ ] Acetylene torch
[ ] Electric tools
[ ] Soldering
[ ] Abrasive saw
[ ] Heliarc welding
[ ] Drilling
[ ] Electric arc
[ ] Propane torch
[ ] Other ,,,,
Hot work to be performed ,,,,
,,,,
,,,,
[ ] Floors swept clean of combustibles
[ ] Fixed combustibles and flammables 10m horizontally and vertically from heat source?
[ ] Inert gas blanket required?
[ ] Ventilation required?
[ ] Respirator for welding or cutting fume required?
[ ] Building or area air currents and outdoor wind direction known?
[ ] Flammable or combustible gas and oxygen levels checked?
[ ] Signage posted for special danger, caution, warning?
[ ] Trenches over 1.5m deep shored or sloped?
Responsible or competent person name ,,,,
Signature ,,,,
Format courtesy of SRT, 080077825327, 0800SRTCLEAN
PHOTO; Consequences of uncoordinated hot work could be severe.
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