HOT WORK PERMIT FORM

(For Company Use Only)

Permit Details

Company Name

Permit No

Department / Section

Date Issued

Valid From

Valid To (Max 8 hours)

1. Work Details

Exact Location of Work

Nature of Work

Welding Gas Cutting Grinding Soldering Other:

Job Description

Equipment / Tools Used

2. Personnel

Permit Requester (Employee/Contractor)

Hot Work Operator(s)

Supervisor Responsible

Fire Watch Assigned (Name & Contact)

3. Mandatory Safety Checks (To be Verified Before Work Starts)

Work area inspected and cleared of combustible material Flammable liquids/gases removed or isolated Fire blankets/screens provided Fire extinguishers (minimum 2) available & functional Adequate ventilation ensured Gas cylinders secured and hoses checked Sparks/heat containment provided PPE provided and used (helmet, gloves, goggles, shield, respirator if required) Work area barricaded and safety signages posted Fire watch assigned during and 30 minutes after work

4. Gas Test Results (If Applicable)

Oxygen Level (%)

LEL (Explosive Gas) (%)

Toxic Gas (Type/Reading) ppm

Test Done By

Date/Time

5. Authorization

Permit Issuer Name

Signature

Date

Area In-Charge Name

Signature