HOT WORK PERMIT

Display this permit at the site of work

This permit shall be applied by employee or contractor before hot work is permitted outside a Hot Work Designated Area.

1. Competent Person carried out the HOT WORK:

Company Name (contractor only) : ____________________ Telephone No :
Name of Performing Person : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Name of Performing Person : _ _ _ _ _ _ _ _ _ _ _ _
Name of Performing Person : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Name of Performing Person : _ _ _ _ _ _ _ _ _ _ _ _

2. Scope of HOT WORK (Likes Brazing, Cutting, Grindings, Soldering, Torch-applied roofing and Welding):
a. Description of job: Welding & Fitting Permit Date: _ _ _ _ _ _ _ _ _ _ _ _ _
_______________________________
Start (Time): _ _ _ _ _ _ _ _ _ _ _ _ _
b. Location where this job is done: End (Time): _ _ _ _ _ _ _ _ _ _ _ _ _

3. Services to be isolated and locked off. ( Please tick)

Services to be isolated Yes NA Services to be isolated Yes NA
Compressed air Hydraulic oil
Electrical (LOTO) Gas supply
Fire fighting System Steam supply
Machinary Lock out Water supply
Fuel oil supply Others: List down:

4. Personnel Protective Equipment (PPE) required for HOT WORK. ( Please tick)
Items Yes NA Yes NA
Safety Shoe Apron
Safety Helmet Gloves
Safety Harness Dust mask
Safety Goggles Respirator
Face shield Other PPE List down:

5. Special precautions (Please tick)

Items Yes Remark
a. Check the hot work equipments/ tools/ chemicals bring in by contractors.
b. Safety briefing to all person at work.
c. Area is barricaded & with warning notice displayed clearly.
d. Adequate ventilation. / Shut down the ventilation and conveying system prior work
e. Fire extinguisher & fire hose Stanby on site.
f. Flammable liquids, flock, lint & oil deposit removed from area of hot work
g. Floor in the vicinity clean/ cleared of combustible materials (minimum 35 ft) or item f
h. Combustible materials/ goods/ area covered completely with flameproof sheets or item e
i. Wet the hot work area, surrounding of floor area & the other side of the wall area.
j. Flammable and combustible materials on the other side of the wall removed
k. All wall and floor openings covered

6. Approval of Permit
Performing Person \ Competent Person :
I understand the nature \ extent of the work. Safety precautions
above to be followed at all time in completing the work safely.
Authorized Person :
I have checked both job and the permit. The permit is approved
within the validity period & all precaution/ safety arrangement to be
adhered at all time for the duration of work.

Signature : _ _ _ _ _ _ _ _ _ _ _ Name : _ _ _ _ _ _ _ _ _ _ _ Signature : _ _ _ _ _ _ _ _ _ _ Name : Navin Robert

7. FIRE WATCH:
Perform fire watch for 2 hours after completion of HOT WORK (To be completed by Fire Watch/ Security Guard)

a) Fire Watch Name: ________________ a. Time Checked : _ _ _ _ _ _ _ _ c. Time Checked : _ _ _ _ _ _ _ _

b) Fire Watch Name: ________________ b. Time Checked: _ _ _ _ _ _ _ _ d. Time Checked: _ _ _ _ _ _ _ _

* INCASE OF EMERGENCY, CALL the contacts listed below before attemping to extinguish the fire.
Name: Tel No.: Name: Tel No.:

Performing Person \ Competent Person : Authorized Person :

The work has been completed and all persons under my The work and area has been inspected & confirm restore to
supervision, material/ equipment have been withdrawn from normal condition. This work permit is hereby cancelled.
the work area.
Signature _ _ _ _ _ _ _ _ _ _ _ _ Signature _______________
PF HS 03(1) -E