HEALTH, SAFETY & ENVIRONMENTAL (HSE)

HOTWORK PERMIT Form ID: NBHH-HSE-FM-003 Rev. No: 01 Date: 01-07-2024

AL HUDAYRIAT ISLAND PDA INFRASTRUCTURE - INFRA 3A & 3B ABU DHABI

JOINT SITE INSPECTION IS REQUIRED WHEN ISSUING A PERMIT
Location: Permit No:
1. WORK DESCRIPTION
This permit-to-work (PTW) is to be retained by the Work In-Charge/Work performer while work is in progress and must be
displayed in the working area. A copy of this PTW must be retained by the issuing authority.
After completion of job Return the signed, completed permit to Issuing Authority for the hand-back procedure.
Name: Designation Time: From: To:

Company: Tel. No# Date: From: To:

Fire Watchman Name No. of persons involved:

Exact Work Location: Subcontractor Name if involved?

Description of Work

TYPE OF HOT WORK ☐ARC Welding ☐ Gas Cutting ☐ Other? __________________

2. PRECAUTIONS REQUIRED (To be filled by Permit requestor): Tick the required precautions
Is Risk Assessment available? Gas cylinders are kept vertical and prevented from toppling
TBT Conducted, recorded and attached with this PTTW Protective clothing worn by operatives
Suitable fire extinguisher provided? Eye protection worn by operatives.
Hot Work area barricaded and signage provided Welding gloves available and worn by operatives
Fire Watchman identified and available Is gas test required and done?
Ventilation available Gas cylinders are free from any leakage
Flashback arrestor available in the gas cylinder
Is there any combustible / flammable materials kept nearby
Electrical connections/cables are free from any defects
Check the work area, if any potentially affected surrounding areas are inspected for fire, for a minimum of 30 minutes (cooling time)
following the completion.
3. Permit Request (Work In-Charge)
Name of Work In-Charge: Nominated Work Performer Name:
I have personally viewed the area, assessed the hazards, and shall make sure that necessary precautions Designation: Date & Sign:
are implemented for this work. I nominated above mentioned foreman as work performer and have made
him and his team understood the requirements of this PTW and ensure their adherence to it.
4. Permit Authorization (Construction Manager)
I, as an issuing authority declare that the above work has been discussed with the person(s) in charge of Designation: Date & Sign:
the work, the risk assessment / method statement has been reviewed and all safety precautions / actions
required are in place have been inspected by myself in accordance with this PTW requirements.
5. HSE Verification
HSE Comments/Recommendations: Name & Designation: Date & Sign:

6. Revalidation of PTW
The maximum duration of this permit is 7 days, PROVIDING NO CHANGE TO THE TASK OR CONDITIONS HAS OCCURRED.
The Date, Time on and Time off must be completed and signed by the Issuing Authority and Work In-Charge to revalidate the permit.
Day – 2 Day – 3 Day – 4 Day – 5 Day – 6 Day – 7
Date
Time on & off
Sign – WI
Sign – HSE
7. WORK COMPLETION / CANCELLATION.
☐ All works Completed on this PTW, all persons, materials and equipment involved have been withdrawn and site left clean, tidy and safe.
☐ All works on this PTW has been suspended and PTW cancelled by HSE Responsible.
(Work In-charge) Name: Sign: Date & Time:
Authorized Person: Name & Designation: Date & Sign:
The work covered by this PTW is complete and the area has been left safe, clean, and tidy.

IN CASE OF EMERGENCY PLEASE CALL PROJECT EMERGENCY NUMBER - +971 50 728 8240