Hot Work Permit

13-06-2016 No.:

Contractor (company or department):................................................................................................................................................................

Location (company, building, storey, room):.......................................................................................................................................................
 Blowtorch Cutting / Welding  Grinding  Brazing  Shrinking/Hot-bonding  Roof work  .......................................................
Work order:........................................................................................... to be carried out by:............................................................................
Beginning of work:...................................... Planned end:.................................... Actual end:..........................................................................
Maximum validity: 1 shift
Emergency number: Nearest phone / push-button alarm:

Measures to be taken prior to beginning with the work

Topic Action Req.* Compl.**
Define the hazardous area, cordon off the area (radius at least 10 m, secure steel grating floors below)  
Safety instructions by the supervisor  
Remove any inflammable substances (gases, liquids, solids)  
Work area or cover with non-combustible panels, mats  
Wash/clean pipes/containers/appliances  
Cover/close openings, cracks, joints  
Inspect safety of work equipment  
Provision of extin-  CO2  Dry powder  Foam  Water extinguisher  
guishing agents  Wall hydrant, pressurised hose in work area  
1. Supervisor 2. Executing contractor 3. Fire watch

If fire alarm systems are shut down, inform / coordinate with fire brigade
Plant technology  
Specify alternative measures!
Fire watch Instructions for fire watch  
Other  
Measures to be taken during the work
Topic Action Req.* Compl.**
Fire watch Continuous inspection of the hazardous area (also during work breaks)  
Person who carries out the work must secure the work equipment (close valves on gas cylinders, isolate
Interruption  
electrical equipment)
Measures to be taken after completion of the work
Topic Action Req.* Compl.**
Remove all work equipment from the area  
Work area
Remove all covers with due care and attention  
Reconnect automatic fire alarm system  
Fire alarm system
Inform fire brigade  
Inspection for up to 30 minutes after completion of the work (fire extinguishers at the workplace)  
Supervision of the
Checks every ½ hour for up to 4 hours (fire extinguishers at the workplace)  
work area
Mobile fire alarm system  
Completion Remove barricade  
(after the Remove fire extinguishers and take them back to their correct location  
supervision) Record any incidents, if applicable  
Release of the work
Parties Action Name Date/ Signature
involved (in print) time
Supervisor Above listed measures are appropriate to cover any hazards that might occur
The work may only be started once all required fire protection measures
Executing have been implemented and the fire watch is present
contractor
Knowledge of the listed measures
Fire watch Has taken note of the listed measures
Transfer of the workplace following completion of the work
Parties Action Name Date/ Signature
involved (in print) time
Executing Execution of the listed measures
contractor
Fire watch Execution of the listed measures
403-HRC316 201603

Supervisor Execution of the listed measures and reconnection of fire alarm system
*Required ** Completed

Further explanations and examples of protection measures are listed in the HDI “Hot Works” Risk Engineering Guideline.

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