HOT WORK PERMIT

HOT WORK DONE BY: REQUIRED PRECAUTIONS CHECKLIST

Available sprinklers, hose streamers, & extinguishers are in service

CONTRACTOR INTERNAL /operable.
DATE: WO # Hot work equipment in good repair.
BUILDING NAME, BLDG #, ROOM #, LOCATION Requirements within 35 ft. of work
Flammable liquids, dust, lint, and oil deposits removed.
Explosive atmosphere in area eliminated.
NATURE OF JOB
Remove other combustibles where possible. Otherwise protect w/ fire
resistant tarpaulins, screens, or shield.
All walls and floor openings covered.
Fire resistant tarpaulins suspended beneath elevated hot work.
NAME OF HOT WORK OPERATOR Work on walls or ceilings/ enclosed equipment
Construction is noncombustible and without combustible covering or
insulation.
I verify the above location has been examined, the precautions Combustibles on other side of walls moved away.
checked on the Required Checklist have been taken to prevent fire, and
permission is authorized for work. No danger exists by conduction of heat into another room or area.
NAME Enclosed equipment cleaned of all combustibles.
Containers purged of flammable liquids and vapors.
COMPETENT HOT WORK SUPERVISOR (CHWS) Fire watch / Hot work area monitoring
Fire watch will be provided during and continuously for 30 minutes after
CONTACT # FAX # work including during any work breaks.
Fire watch is supplied with suitable extinguishers.
DATE
Fire watch is trained in use of this equipment and in sounding alarm.
PERMIT REQUEST

TIME: AM PM Fire watch maybe required for adjoining areas, above and below.
DATE Hot work area inspected 30 minutes after job is completed.
PERMIT EXPIRES
TIME: AM PM Other precautions taken
SIGNATURE OF CWHS (To be signed during inspection) Confined space entry permit required.
Area is protected with smoke or heat detection.
Ample ventilation to remove smoke/vapor from work area.
EH&S Approval EXPIRATION DATES Lock-out / Tag-out required.
Comments:

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