Hot Work Permit to Work Template
1a2b3c / 24 Sep 2021 / Brad Smith Complete
Score 100% Failed items 0 Actions 0
This Hot Work Permit is required for any operation involving open flames or producing heat and/or sparks. This
includes, but is not limited to, Brazing, Cutting, Grinding, Soldering, Thawing Pipe, Torch-Applied Roofing, and
Welding.
Permit No. 1a2b3c
Site Location Avenue 20, Stapleton, NE 69163,
USA
(41.4876148, -100.6945613)
Conducted on 24 Sep 2021 16:07 PST
Prepared by Brad Smith
Private & Confidential 1/4
Audit 100%
Audit- 100%
Nature of Job/Object Welding of second floor railings
Required Precautions Checklist 100%
Required Precautions Checklist
- 100%
Available sprinklers in normal automatic mode and valve open. ✔
Hot Work equipment in good repair. ✔
Using the new welding equipment today.
Assess 35 ft radial “sphere” of work for potential fire hazards:
Floors, work level and below, cleaned or protected. ✔
Floor directly under the hot work also taken cared of.
All other combustibles removed or shielded from sparks. ✔
Clean horizontal surfaces (e.g. building structures, equipment, ducts, cable
✔
trays, etc.) above and below where possible.
Remove flammable liquids, dust, lint, combustible waste, oil deposits, etc.,
✔
where possible.
If removal/cleaning is impractical, protect with fire-retardant covers, or
N/A
shield with fire-retardant guards and/or curtains.
Transmission or conveying of sparks to adjacent areas eliminated or
✔
protected.
Tightly cover wall/floor openings with fire-retardant material. ✔
Where openings cannot be sealed, suspend fire-retardant tarpaulins to
✔
help protect areas beneath.
Isolate or shut down fans and conveyors to prevent the capturing and
N/A
conveying sparks to other areas.
No fans at this area.
Explosive atmosphere eliminated or potential not present. ✔
This is open air.
Work on walls, ceilings or enclosed equipment:
Construction materials verified as noncombustible and without
✔
combustible covering or insulation.
Combustibles on another side of walls relocated or protected. ✔
Enclosed equipment cleaned and protected from all combustibles. N/A
No other equipment in the vicinity.
Private & Confidential 2/4
Containers purged of flammable liquids/vapors. N/A
No containers around.
Fire watch/hot work area monitoring requirements:
Continuous fire watch provided during and for at least 30 minutes after hot
✔
work, including all breaks.
There is even a fire watch even on the lower floor.
Fire watch supplied with suitable extinguishers/hoses. ✔
fire extinguishers on both floors
Fire watch trained in the use of fire equipment and sounding alarm. ✔
Area to be monitored hourly for a minimum 6 hours after job is completed,
✔
or longer if required.
we have security watching over the job site 24 hours
Other precautions that may be required:
Fire watch provided for adjoining areas, above, or below. ✔
both floors have fire watch
Confined Space or Lock-Out-Tag-Out required/used. N/A
hot work location is open air
Area smoke or heat detection disabled to eliminate false trip. ✔
disabled for the duration of the hot work
Completion
Completion
Full Name and Signature of Permit-Authorizing Personnel
Brad Smith
24 Sep 2021 16:18 PST
Click + to add names of persons doing the hot work
Employee
Employee
Employee 1
Employee 1
Private & Confidential 3/4
Full Name and Signature of Person doing the hot work
Tommy Jones
24 Sep 2021 16:21 PST
Private & Confidential 4/4
