Hot-Work-Permit-Form.pdf

HOT WORK PERMIT PERMIT DETAILS Permit Number Date Issued Start Date and Time End Date and Time Location/Work Area WORKER DETAILS Name Worker ID...

HOT WORK PERMIT PERMIT DETAILS Permit Number Date Issued Start Date and Time End Date and Time Location/Work Area WORKER DETAILS Name Worker ID Gender Skillset HOT WORK ACTIVITY DESCRIPTION RISK ASSESSMENT Has a risk assessment been conducted for the hot work activity? YES No DECLARATION I hereby declare that I have: 1. Conducted a thorough inspection of the work area and identified potential hazards. YES No 2. Ensured all necessary precautions have been taken to mitigate risks. YES No 3. Verified that all personnel involved in the hot work activity have received appropriate training YES No and possess the required skills. 4. Confirmed that all relevant permits, licenses, and authorizations have been obtained. YES No 5. Verified that the work area is free from flammable or combustible materials. YES No 6. Confirmed the availability and adequacy of fire prevention measures and fire extinguishers. YES No  7. Ensured proper isolation of the work area from unauthorized personnel. YES No 8. Assigned and briefed fire watchers on their responsibilities. YES No 9. Provided workers with appropriate personal protective equipment (PPE). PPE Checklist: Safety glasses/goggles Welding helmet Welding gloves Flame-resistant clothing Welding apron Respiratory protection (if required) Hearing protection (if required) Other (specify) 10. Established a communication plan for emergencies. YES No 11. Conducted a final inspection before authorizing the hot work activity. YES No 12. Communicated all necessary safety precautions to workers. YES No 13. Confirmed the suitability of weather conditions for hot work. YES No 14. Ensured the proper shutdown and isolation of nearby equipment and machinery. YES No 15. Implemented a permit-to-work system. YES No 16. Verified that workers have received proper training on hot work safety. YES No 17. Established and communicated an emergency response plan. YES No DECLARATION I hereby declare that all necessary precautions and safety measures have been taken, and I understand and accept the responsibility for the safe execution of the hot work activity described above. Name, signature and date: Approver 1 Approver 2 Approver 3 Permit template by: Digitize your Permit Management through Safetymint Get started with a free trial at www.safetymint.com