Hot Work Permit PTW/HWP/_____________
SecƟon 1: Work Details
General PTW Serial No.: Work Loca on:
Work to be done:
Working Date: From: Un l:
SecƟon 2: Safety Checklist
Hot work permit expires at the end of work shiŌ day. Please review the hot work permit DAILY by going through the Safety
Checklist below and approved the renewal in Sec on 3.
Remarks: (√: DONE) (X: NOT DONE) (NA: Not Applicable)
No. Items
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Read and understand the Hot Work
1 Procedure OCP 12 - Hot Work
Management Procedure.
Work area and equipment has been
made free of flammable,
2
combus ble, and hazardous
materials.
Gas Test taken for area near to source
3
of flammable gas.
Is a fire ex nguisher available for the
4
job?
Are smoke alarms covered? (if
5
applicable)
Are lines disconnected and/or
6 blanked? Are isola on packages
available and implemented?
7 Is a fire watch provided?
Other necessary precau ons (if
available)
8
Please specify:
Permit Applicant (Signature):
Permit Applicant (Name):
Date:
SecƟon 3: Hot Work Permit Review & Approval
I have personally checked the condi ons necessary and as specified I authorized this hot work to begin.
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Permit Issuer (Signature):
Permit Issuer (Name):
Designa on:
Date:
Time:
SecƟon 4: Hot Work Permit Closure
I have personally checked the condi ons necessary. Any con nua on of work for next day require comple on of Sec on 2:
Safety Checklist and approval from Permit Issuer.
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Permit Issuer (Signature):
Permit Issuer (Name):
Designa on:
Date:
Time:
