Project Name:
Project Name:
Owner: Hot Works Permit
#VALUE! Contractor:
This Hot Work Permit is required for any temporary operation involving open flames or pruducing heat and/or sparks.
This includes, but not limited to: Brazing, Cutting, Grinding, and Soldering, Thawing Pipe, Torch Applied Roofing, and
Welding
INSTRUCTIONS REQUIRED PRECAUTIONS CHECKLIST
1. Fire safety supervisor ___ Available sprinklers, hose streams and extinguishers
A. Verify precautions listed at right (or do are in service/operable.
not proceed with the work) ___ HOT WORK equipment in good condition.
B. Complete and retain this permit.
Requirements within 10m (35ft.) of work
HOT WORK BEING DONE BY: ___ Flammable liquids, dust, lint, and oily deposits removed.
__ EMPLOYEE ___ Explosive atmosphere in area eliminated.
__ CONTRACTOR: ___________________________________ ___ Floors swept clean.
_______________________________________________________ ___ Combustible floors wet down, covered with damp sand
_______________________________________________________ or fire-resistive sheets.
DATE: _____________ JOB NO. __________________ ___ Remove other combustibles where possible.
LOCATION/BUILDING & FLOOR: Otherwise protect with fire resistant tarpaulines or metal
shields.
NATURE OF JOB: ___ All wall and floor openings covered.
___ Fire resistant tarpaulins suspended beneath work.
Work on walls or ceillings/enclosed equipment
NAMES OF PERSON DOING HOT WORKS: ___ Construction is noncombustible and without
combustible covering or insulation.
___ Combustibles on other side of walls moved away.
___ Danger exist by conduction of heat into another area.
___ Enclosed equipment cleaned of all combustibles.
___ Containers purged of flammable liquids/vapors.
___ Pressurized vessels, piping and equipment removed
from service, isolated and vented.
Fire watch/hot work area monitoring
___ Fire watch will be provided during and 30mins after
work, including coffee or lunch breaks.
___ Fire watching is provided with suitable extinguishers
___ Fire watch is trained in use of this equipment and in
I verify the above location has been examined, the sounding alarm.
precautions checked on the required precautions ___ Monitor hot work area for 30 minutes after job is
checklist have been taken to prevent fire, and completed.
permission is authorized for this work.
Other precautions taken
SIGNED (FIRE SAFETY SUPERVISOR/OPERATIONS ___ Confined space entry permit required.
SUPERVISOR: ___ Area protected with smoke or heat detection.
___ Ample ventilation to remove smoke/vapor from work
PERMIT EXPIRES area.
___ Lockout/tagout required.
DATE: TIME:
NOTE: EMERGENCY NOTIFICATION ON BACK OF
FORM. USE AS APPROPRIATE FOR YOUR FACILITY.
THIS PERMIT IS GOOD
FOR _____ DAY/S ONLY
Evaluated by: _______________________________ Noted by: _________________________________
Safety Officer Construction Manager
