Format: Frm/Ehs/04 Revision No. - Rev. 00: Hot Work Checklist: N/A Yes Na

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FORMAT: FRM/EHS/04

Revision No. Rev. 00


Hot Work Permit
Date and Time Issued: _______________ Date and Time Expires: ________
Job site/Space I.D.: ________________ Job Supervisor: ________________
Equipment to be worked on: __________
Work to be performed:
_______________________________________________________________________
_______________________________________________________________________
HOT WORK CHECKLIST:

N/A

Yes

NA

1. Job Site Checked:

( )

( )

( )

2. Combustibles removed:

( )

( )

( )

3. Area cordoned off:

( )

( )

( )

4. Sparks isolated:

( )

( )

( )

5. Explosion test done:

( )

( )

( )

6. Welding Set earthed:

( )

( )

( )

7. Adequate ventilation for fumes

( )

( )

( )

8. Fire Extinguishers provided

( )

( )

( )

9. Fire watch in place

( )

( )

( )

10. Precautions to be taken, if any ___


__________________________________________________________________
_______________________________________________________________________
PPE TO BE USED: [Tick whichever is applicable]
1. Helmet:

[ ] 5. Welding goggle:

[ ]

2. Safety Shoes:

[ ] 6. Gloves:

[ ]

3. Gum boots:

[ ] 7. Respirators / Mask

[ ]

4. Welding face shield: [ ] 8. Apron

[ ]

This permit is valid only for cleaning and general maintenance activity.
This permit is not valid for carrying out Hot Work, Height Work,
Confined Space and Lock Out and Tag Out. This permit is
not valid unless all appropriate items are completed.

FORMAT: FRM/EHS/04
Revision No. Rev. 00

Permit Prepared By: (Executive - Maintenance)


Name:________________________________Signature:______________________
Approved By: (Production-in-charge)
Name:________________________________Signature:______________________
Permit Acceptance [in case of contract job]:
I have been explained the contents of this permit and have been
provided necessary PPE. I shall be responsible for supervising the job.
I assure you to follow all safety precautions.
Name of the contractor:_____________________________
Signature: ___________________________________
This permit to be kept at job site. Return job site copy to Production
Office following job completion.
Copies:

White Original (Production Office)


Yellow (Job Site)

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