FMD-F-11-02.14.1.4.

HOT WORK
PERMIT
Date Prepared: Date of Work:
Company Name:
Welder's name:
Firewatch Personnel Name:
Emergency Contact No.
Work Description (specify):

Type of Hot Work:

Electric Welding Oxy-fuel Welding Grinding
Cutting Others (pls.specify):
Location of Work:
Time Hotwork Started: Time Hotwork Ended:

Safety Checklist:
Welding hose, torches, power & ground cables are in good condition
Cylinder tank cart with strap provided
Valve cap for cylinder tank provided
Flammable/combustible materials are removed / isolated / covered with metal sheet or non-combustible cover.
At least one (1) 20 lb. Multipurpose ABC Dry Chemical fire extinguisher provided.
Dedicated fire watch personnel (must also be present 30 mins. before and after hot work)
Fire watch personnel is oriented on the facilities and emergency procedures (e.g. sounding the alarm,
fire suppression, etc.)
Mechanical means of ventilation and exhaust provided
Appropriate standard approved PPEs are in-good condition and well-maintained
Read and understood Material Safety Data Sheet (MSDS) of electrode/fuel gas
Work area thoroughly inspected
Qualified & well-trained worker
Other equipment e.g. extesion cords are in good condition
Insulated working platforms for arc welders that have to work on damp area
Smoke/heat detector covered (coordinate with PM/BE/TA)
I hereby certify that all the data provided above are correct, and that all works to be done within the
duration of this permit will be in accordance with the House Rules & Regulations / Construction Guidelines
set by ALI/APMC.
We have understood all provisions and rules in the pre-work safety orientation as conducted by the
APMC Administration.

Requested by: Noted by:

Printed Name & Signature of Printed Name & Signature of
Contractor Proj. Owner

Approved By:
(PM / BE / TA) Date Signed

Remarks:

*Accomplish this form in two (2) copies: (1) Contractor's Copy and (2) Security/APMC Copy
Rev.00