Hot Work Permit

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UNITED INDUSTRIAL SERVICES CO. L.L.C.

Permit No. HOT WORK PERMIT Date:


Name of the Initiator (Supervisor / Engineer): Company :
Location:
Work to be performed:

Vehicle / Tools / Equipment Involved:

Crew Strength:

Planned work duration: Hrs. From : To:


No Flammable material in the surrounding Yes Remarks if any:
Ventilation / Fume extraction available Yes
Screen provided to control sparks Yes
Fire Extinguishers / Fire Watcher in place Yes
Specific Hazards & Controls

Hazards Controls

Validation by Permit Authority (HSE )

Note:Permit Initiator to hand over permit to the Foreman / Chargehand after briefing /
discussing the contents for executing the activity with necessary controls.
Controls verified and found adequate

Signature
Initiator Signature Engineer/Supervisor Safety Engineer/Officer

UNISCO[PF]HSE-19 REV -00 15/07/16

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