BU PROJECT

HOT WORK PERMIT

N°: Date: Company: Site: Area: Workers:
Work Descriptiopn
PERFORMING AUTHORITY

Equipment & Tools

Hazards Identification VISA

Flammable Matierials Rotating Machinery Live Electricity Excavation Specifiy if PA
Presence of Gas Moving Part Static Electricity Scaffolding other Name
Hazardous Material Manual Handling Electrical Equipment Weather Conditions Title
High Pressure Heavy Lifting High Temperature Night Work Date
Noisy Area Working at Heights Heavy Equipment Other Visa
Certificates IA
Confined Space Electrical Isolation Excavation Clearance Name
N° N° N° Title
ISSUING AUTHORITY

Mec, Process & Inst Isolation Radiation Scaffolding Date

N° N° N° Visa
Preventive Safety Measures PTW Coordinator
Fire Extinguisher Chemical Gloves Safety Harness Lighting Specifiy if Name
Gas Detector Apron Face Sheild Atex Equipment other Date
Fire watchman Respiratory Protect Fall Arrestor Breathing Apparitus Visa
Hard Barrier Ear Plugs Safety Harness Communication Construction Manager
Chemical Suits Warning Signs Ventilation Other Name
Other Recommendations & Comments Date
Visa
HSE Supervisor
Name
Date
Visa
Inspection Comments, To identify the action party
AUDIT

Day 2 Day 3 Day 4 Day 5 Day 6 Day 7

Date
EXTENTION

PA
IA
HSE Sup
Date PA IA PTW Coordinator Const Manager The work cancelled Due to:
SUSP.

PA IA HSE Supervisor Construction Manager

Date: Date: Date: Date:
COMPLETION

Name: Name: Name: Name:

Visa: Visa: Visa: Visa: