Description:
Hot Work Permit
ISSUE: 00 DATE: 18.02.2019 REV: 00 FORM NO. ITC1-HSE-F-007
Project: Permit #
SECTION 1 - DESCRIPTION
Location
Description of Work
Permit required for
(Name of Company)
Date and time
Task in charge
Welder Name
SECTION 2 - CHECKLIST
No. Description YES NO Remark
1 Work area & below the work spot is cleared from all combustible materials.
2 Fire fighting equipment and water available at the work area.
3 Tin sheet / fire blanket to prevent sparks from spreading.
4 Flash back arrester installed to the gas cylinder.
5 Gas cylinder and fittings are free from cracks, grease, etc.
6 Gas cylinders are kept upright and secured.
7 Arc welding machine is in good condition.
8 Welding cables are in good condition.
9 Operatives engaged are in possession of the appropriate PPE.
10 Stand-by fire watcher. ( Name)
11 Gas Leak Checked by (Name)
SECTION 3 - INSPECTION & APPROVAL
This work permit for the above mentioned work at the location specified is issued after personally inspecting the area to
ensure that the precautions mentioned in Section 2 have been complied with.
This Permit is valid from …………………. Hours to ………………….. Hours on date …………………(1 day only).
Permit Requested By: Permit Inspected by
Engr. / Supervisor: …………………………………………… Fire Wardan (L&T) …………………………………………….
Company: Signature: …………………………………………….
HSE (L&T) Dept
Signature: ………………………………………………………………………
Signature: …………………………………………….
For NSC Permit approved by:
HSE Officer: ……………………………………………………………………
HSE (L&T) Dept. ……………………………………………..
Signature: …………………………………………………………….. Signature: ……………………..………………………..
SECTION 4 - Renewal Of the Permit
This work permit validity is extended for following date:
1) ………………………………………………………….. HSE (L&T) Dept. ………………………………………
SECTION 5 - CLOSEOUT OF PERMIT
Actual work completed and the area has been cleared. Permit closed
Time Date HSE (L&T):
(To be returned to the Safety Officer of L&T once the work is completed)
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Date: ………………. Location:………………………..
Time Fire Watcher Signature Fire Wardan Signature
8.00-9.00
9.00-10.00
10.30-11.30
11.30-12.30
13.30-14.30
14.30-15.30
16.00-17.00
17.00-18.00
18.00-19.00
19.00-20.00
20.00-21.00
21.00-22.00
22.00-23.00
23.00-00.00
00.00-1.00
1.00-2.00
2.00-3.00
3.00-4.00
4.00-5.00
5.00-6.00
6.00-7.00
Supervisor HSE Officer
Name:………………………………. Name:……………………………….
Signature:……………………………. Signature:…………………………….
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