Ref: DWE-COS-HSE-TMP-00003

Rev: A.0
HOT WORK CHECKLIST Date:07-AUG-2021

DWMC Project Page: 1/1

PERMIT NUMBER:
PART 1 – Activity information
Company: RAMS Reference:
Precise location(s) of activities:

Description of activities:

Permit duration (date & time) Start: Finish:

CONTROLS checked by Issuing or Area Authority/ Yes No N/A CONTROLS checked by Issuing or Area Authority/ Yes No N/A
Automatic fire detection and suppression systems suitably
Isolation of any combustible/flammable/explosive services
deactivated
Protection of any combustible solids, flammable liquids or Provision of water/dry powder/carbon dioxide/foam fire
dusts in close proximity extinguisher(s)
Fire watcher to remain in work area at all times and for 1 Equipment to be fitted with flashback arrestors/non-return
hour cool down period at the end of each hot work period valves

Confined space atmospheric testing Gas cylinders kept upright and at least 3m from burners

Adequate means of raising the alarm and emergency Correct protection for workers involved in the task and
escape route and first aid/emergency procedures available workers or visitors who may be close by

Screen to contain sparks & weld spatter Is or Electrical or Mechanical isolation needed?

Additional controls:

Part 2 - Declaration of worksite readiness by Area Authority or Issuing Authority

Name: Position:

Signature: Date and Time:

PART 3 – ISSUED by Issuing Authority (Permission is granted to conduct the work described above)

Name: Position:
Signature: Date and Time:

PART 4 – Received by Performing Authority

As the supervisor, I am familiar with the scope of work and safe systems to be implemented.
A briefing has been delivered to the workforce on this safe system of work.
Name: Position:

Signature: Date and Time:

REVALIDATION
Start (date and time) Finish (date and time) Issuing Authority or Area Authority Performing Authority

PART 5 – Completed by Performing Authority

The Hot Work activities authorised by this permit have finished and all sources of ignition removed.
The work area and all adjacent areas to which sparks or heat could have spread, were thoroughly inspected and declared safe.
Name: Position:

Signature: Date and Time:

PART 6 – Cancelled by Issuing Authority
The activities authorised by this permit have now ceased. No more Hot Works are allowed until further notice.
Name: Position:

Signature: Date and Time:

DWE-COS-HSE-TMP-00003 - A.0 - Hot Works Checklist 30/11/2021 06:54