HOT WORK PERMIT
Date: XX/XX/202X Permit No.: HG-00010
Site:
Location:
Work to be performed:
Persons Involved:
Name:
Designation:
Phone No.:
Name:
Designation:
Phone No.:
Name:
Designation:
Phone No.:
Supervisor Incharge:
Name:
Phone No.:
Safety Checklist:
Adequate fire extinguishing equipment available at the work
location
Designated fire watch personnel during and after the hot work
All personnel involved are wearing appropriate PPE
Proper ventilation available to minimise the accumulation of
flammable gases and vapours.
All hot work equipment is in good condition and suitable for the
task.
Emergency contact numbers and procedures displayed at the
work location.
The work area is cleared of flammable materials.
Combustible materials removed or protected with flame-resistant
covers.
Duration:
The permit is valid from _______________ to _______________
I, the undersigned, acknowledge that I have read and understood the
requirements and precautions outlined in this Hot Work Permit. I agree
to adhere to the safety measures outlined above.
Signature of Worker: __________________Date: _______________
Signature of Supervisor: _______________ Date: _______________
Signature of Safety Officer: _____________ Date: _______________
