KEC HUB Phase-1
WASAT AL-MADINA PROJECT
MADINATUL MUNAWARA. Saudi Arabia
Permit No
Hot Work Permit H W P 0 0
Date : Time:
Location: Core: Level: Shaft No: Type of Hot Work :___________________
Duration (One Shift Only):
Name of Task Supervisor-(Permit Holder):
Company Name:
Requested by : Approved by :
Name & Signature Name and Signature
Pre Task Inspection Report
Yes No NA
1. Has the immediate area been cleared of all combustible materials?
2. Fire fighting equipment and water available at work area?
3. Fire blanket in place to contain sparks?
4. Flash back arrestor fitted to gas cylinder?
5. Gas cylinder and fittings free form cracks, damage, grease?
6. Gas cylinders stored in appropriate trolley or upright and secure?
7. Arc welding machine in good condition (TPI certificate available)?
8. Welding/Electrical cables in good condition?
9. Are all operators trained and competent for the task?
10. Are all operators are in possession of appropriate task specific PPE for the job?
11. Continuous fire watch is provided during and at least 30 minutes after the
Hot work is completed in order to detect and extinguish smoldering fires?
Name:-
10.Emergency Contact Numbers:
CONTACT NO.
Site Emergency No:
Emergency Services; 999/997/998
Permit Issued by:
Name: Signature:
Declaration by Permit Holder: I declare that I have checked the work location and that I have carried out the
pre-task check list above. All participants are trained and competent and have been given a TBT prior to
commencing work. (See over)
Name : Signature:
HSE Dept Review
Comments:
Name: Signature:
Permit Close Out
Date:
Time:
Fire Check Conducted at (Minimum 60 mins after cease work):
I declare that all work is complete for the day, all men have been withdrawn from the area, all safety barriers
replaced and that a post task fire check has been carried out and the area has been left in a safe condition:
Permit Holder Signature: Permit Issuer Signature:
____________
We the undersigned have received a TBT on Hot Works and agree to comply with the specific
instructions listed overleaf:
Name (Print) Company Signature Date
