HOT WORK PERMIT

WELDING GAS CUTTING BRAZING GRINDING Others

PERMIT NO DATE

Section – I CONTACT DETAILS

Project / Section Location (s)
Permit Receiver Contact Number
Engineer Responsible Contact Number
Name of the Welder/Operator Pass number
Section – II PERMIT VALIDATIONS
Date issued Valid Till (Not more than a shift)
Time Issued Valid Till (Expires after 0001 hrs)
HOT work permit shall not exceed for more than a day (shift) and should be closed accordingly.

Section – III PREREQUISITE (Work May be stopped if one of the following is not complied with)

 for YES and X for No Yes NA  for YES and X for No Yes NA
A Flammable Materials removed from location K Proper Access to the Hot work area
B Welding Gensets terminal insulation L Safety/Warning Signs in place
C Adequate Earthing M Adequate Ventilation
D Area of work clean and dry N Power Tools/Equipment safe for use
E Appropriate Fire Extinguisher Provided O Adequate illumination
F Operatives trained in using fire extinguisher P Flash Back arrestors - Gas Cylinders
G Fire Blankets (non flammable) Provided Q Cylinders Kept in trolley and secured
H Fire Watch Personal R Regulators in good condition
I Area barricaded S Gas test required
J Appropriate PPE Provided T Isolation of Equipments required

DECLARATION BY THE PERMIT APPROVER (AP) DECLARATION BY THE PERMIT RECEIVER

I representing MAK, hereby declares I _________________ representing _________________
that after checking the work location, Providing the identified hereby declare that I will fulfil above mentioned all
resources, Works and Emergency procedures - being briefed to requirement prior to the Hot work operation and follow the
the team, hereby Approves the works to proceed. safe work procedure

Date:……/……/…… Name……………… Signature: …………….. Date: …/…/… Name; …………………Signature: ………..

Section IV PERMIT CONTROLLER
Work shall be carried out ONLY after complying with the precautions given in Section – III of this Permit.
The permit is valid up to hrs. on __. It has to be ensured that the employee executing the Job has a copy of the
permit at all times during work. No equipment’s shall be left unattended at any time whatsoever the reason may be. Prior to any
accessory replacement the tool must be disconnected from the main source of power supply. Before closing the PTW, area has
to be rendered harmless.
Name of the Safety Officer: …………………. Signature …………………………… Date …………………..
CMA
Remarks:
Name: Signature: Date:
Section V PERMIT CANCELLATION
PERMIT CANCELLATION : The Hot Work is Completed and the
area is safely secured ( Permit Receiver ) Date: ……/……/……. Time: ………… Signature……………

PERMIT CANCELLATION : The Hot Work is Completed and the

area is safely secured ( Permit Approver / AP) Date: ……/……/……. Time: ………… Signature……………
I confirm after thoroughly checking physically in the aforementioned Hot Work area that proper housekeeping is done, leaving behind the area
safe, hence closing this Hot Work Permit.

DS197/1 MAK/ HSEF - 013

Version – 01, Revision - 02, Dated: 18-09-2019