HOT WORK PERMIT TO WORK
DATE: COMPANY UNDERTAKING WORK: PERMIT NO.
PART 1 (Complete this part before job starts)
LOCATION of work
DESCRIPTION of work
Risk assessment carried out? Yes Area Authority & affected persons informed? Yes
PRE-PERMIT MEASURES taken (eg checks of equipment, tools, preparatory works, PPE put in place and Yes n/a
checked)
Area Work area demarcated with temporary barriers, and warning signs.
demarcation
Area Combustible material and flammable liquids removed (ie >10m minimum).
preparation
All surfaces cleaned of combustible materials (including areas overhead and
underneath).
All containers emptied and purged of combustible materials. Any connections isolated
(LOTO).
Unmovable material and sensitive floors protected with a fire resistant covering.
Work area ventilated as much as possible and air tested. (Normally only required in
potentially explosive atmospheres)
Fire fighting Gas cylinders secured from falling. Extra cylinders stored away from immediate work area.
equipment
Gas hoses protected from damage and trip hazard.
Fire fighting Fire extinguisher (and/or water, if applicable) available.
equipment
Fire blanket available.
Fire detection Smoke/heat detectors disabled. ID numbers: _________________________
Worker Workers are competent to work to carry out task safely.
capability
Additional pre-permit measures to be taken:
PRECAUTIONS required during job (eg safe way of working, use of PPE) Yes n/a
Atmosphere Continuously ventilate work area and monitor for flammable gases.
Standard PPE Wear flame-resistant clothing.
Wear eye protection (safety glasses; specify below if UV protection required).
1 | Hot Work Permit to Work
Case-specific Wear face protection (full shield; specify below if UV protection required).
PPE
Wear protective gloves (eg welding gloves).
Completion & Cool down work-piece, etc before leaving area
inspection
Inspect work area and adjacent areas for hot particles and smouldering after work
completion.
Fire detection Maintain a fire watch during hot work.
& fire watch
Reinstate smoke/heat detectors immediately after hot work is complete. ID numbers:
_________________________
Maintain fire watch after hot work completion. Specify duration:
_________________________
(Minimum 30 mins. in normal situation. 2 hours if combustible materials could not be
removed from area.)
Additional precautions and PPE required:
Food Safety Risk Assessment Done By: ………………………………………………
List down food safety risks associated with the work and how to mitigate against them
PART 2 (Complete this part when job finished)
POST-PERMIT MEASURES required (final works / make work area safe) Yes n/a
Area condition Remove gas cylinders from work area, ensure they are in a safe condition and
secured from falling.
Additional post-permit measures required:
Application of PTW for Confined Space Entry
Criteria for use of PTW Key risks involved
• Any job that could create a source of ignition • Fire and explosion
• Examples include jobs that: • Contact burns.
• Use or could generate heat or sparks (eg welding, flame • Cutting or abrasion of body parts and eye injuries due to
cutting, cutting and grinding) metal splinters
• Could generate sparks in areas where explosive • Hazardous substances, eg harmful gases and fumes
atmospheres could occur. • Electric shock, eg from welding or use of electric hand tools
• A PTW is normally NOT required for hot work in designated • Falling of gas cylinders, tripping over gas hoses, falling of
hot-work area. work-piece
2 | Hot Work Permit to Work
Additional guidance on carrying out the job safely
Preparation of work area: Fire Watch:
• All surfaces in should be cleaned of combustible materials, • The fire watch should not perform any work, but be
including surfaces of ducts, pipes and cable trays. Time constantly alert for fire outbreak and have a fire extinguisher
should be allowed for dust to settle before starting work. (and/or water, if applicable) and a fire blanket available.
• Areas overhead and underneath the work area may need to • In areas below and adjacent the immediate work area there
be cleared, cleaned and protected in the same manner as may be a need of a fire watch as well.
the immediate work area
• Close-off floors, doors, windows and other openings to
prevent sparks spreading to below or adjacent areas.
• Hot work in enclosed spaces (eg tanks, silos, etc) containing
combustible or flammable materials is NOT permitted.
WORKERS
Name Buddy Signature Name Buddy Signature
CERTIFICATION by PTW Issuer: I certify that: a) I have visited ACCEPTANCE by Performing Authority: I certify that: I will
the work area, and reviewed the work & risks involved with the personally supervise the job to ensure that: a) The work is
Performing Authority; b) The controls set out in this PTW will enable carried out within the limits described; b) The controls set out
the job to be done safely; c) The pre-permit measures have been are followed by all workers; c) All workers understand the risks &
implemented; and d) The Performing Authority understands the required controls before they start work; d) The job is stopped &
controls required and is able to implement them. the Permit Issuer notified if requirements change, new risks are
identified, or there is an incident.
Name & Signature Name & Signature
APPROVED BY Date Time Sign
FACILITIES MANAGER
QUALITY ASSURANCE MANAGER
HEALTH & SAFETY OFFICER
Area Authority & affected persons informed? Yes
CLOSURE by PTW Issuer: I hereby close this PTW. No further high- ACKNOWLEDGEMENT by Performing Authority: I understand this
hazard work may be carried out. The post-permit measures set PTW is no longer valid and no further high hazard work may be
out above are sufficient. carried out. I have made the work area safe and communicated
the PTW closure to all members of the work team. I understand
what post-permit measures I need to carry out.
Date & time Date & time
Name & Signature Name& Signature
3 | Hot Work Permit to Work
