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    Hot Work Permit Form

    Uploaded by

    Facility Manager Om Chambers
    The hot work permit document outlines safety procedures and requirements for hot work such as welding or cutting. It requires inspection and approval from an operating supervisor and/or safety department. It also includes a checklist to ensure the work area is cleared of combustible and hazardous materials, has proper ventilation and fire protection equipment, and that the worker has necessary protective gear.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Hot Work Permit Form

    Uploaded by

    Facility Manager Om Chambers
    11 views2 pages
    The hot work permit document outlines safety procedures and requirements for hot work such as welding or cutting. It requires inspection and approval from an operating supervisor and/or safety department. It also includes a checklist to ensure the work area is cleared of combustible and hazardous materials, has proper ventilation and fire protection equipment, and that the worker has necessary protective gear.

    Original Title

    Hot Work Permit Form (1)

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    © © All Rights Reserved

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    The hot work permit document outlines safety procedures and requirements for hot work such as welding or cutting. It requires inspection and approval from an operating supervisor and/or safety department. It also includes a checklist to ensure the work area is cleared of combustible and hazardous materials, has proper ventilation and fire protection equipment, and that the worker has necessary protective gear.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11 views2 pages

    Hot Work Permit Form

    Uploaded by

    Facility Manager Om Chambers
    The hot work permit document outlines safety procedures and requirements for hot work such as welding or cutting. It requires inspection and approval from an operating supervisor and/or safety department. It also includes a checklist to ensure the work area is cleared of combustible and hazardous materials, has proper ventilation and fire protection equipment, and that the worker has necessary protective gear.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    HOT WORK PERMIT

    After this is filled out and signed, send to _________________________ _____________________


    for recordkeeping in the____________________________________ file.

    Type of work:

    Permit is good for one shift only, or not to exceed the time limit. TIME LIMIT: a.m.
    p.m.
    Area: Date:

    Describe work to be done:

    Note: Check Yes or No. If question does not apply, indicate it with N/A (not apply).

    YES NO

    1. Can this equipment be removed from the building?


    2. Have all process materials been removed from equipment?
    3. Have all connections been blanked off and switches been locked open?
    4. Has equipment been ventilated?
    5. Can sparks ignite material in vicinity lower level?
    6. Is the work area clear of all explosive, flammable, and hazardous
    material (35-ft. rule)?
    7. Is all combustible material removed from the work area or protected
    (35-ft. rule)?
    8. Has a fire watch been assessed?
    9. Is an operational fire extinguisher readily available?
    10. Has the nearest fire alarm pull station been located?
    11. Does the operator have the correct personal protective equipment
    (e.g., eye protection, gloves, face shield)?
    12. Is the area where the work will occur adequately ventilated?
    13. Have the dangers associated with the following been eliminated or
    specifically addressed?
    a) Penetrating a pressurized system?
    b) Penetrating a container of hazardous chemicals?
    c) Affecting an item that is potentially radioactive
    d) Damaging property?

    14. SPECIAL PRECAUTIONS TO BE OBSERVED:

    I have personally inspected and approve conditions for above.

    Signed: Department:
    (Operating Supervisor)
    and/or Signed: Time: Date:
    (Safety Department)

    HW.P/ELE5000(12/97)
    Example of the Hot Work 35-ft. (11m) Rule
    Fire
    Door

    Fire Wall Fire Wall

    35 ft. (11m)

    Heavy
    Storage

    Work
    Area
    Rack
    Storage

    35 ft. (11m)
    Cart of
    Canned Palletized
    Paint Storage

     
     

    70 ft. (21m)

    • Remove or shield from sparks all potential


    fuels within 35 ft. (11m) of the work area.
    In this case, the paint cart and palletized
    storage.
    • Empty racks on which the work is to be
    done of all storage.
    • Close fire doors and seal floor openings
    such as the area surrounding process
    piping with noncombustible caulking.
    • Cover heavy combustible storage that is
    impractical to move with a fire-resistive
    material.

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