Hot Work Permit

Hot Work Permit

HSEOP-10-12
Seek an alternative / safer method if possible!
This Hot Work Permit is required for any operation that involves burning, welding, using an open flame, fire, or spark-producing tools, or that produces a source of ignition. This work includes, but is not limited to, welding, brazing, cutting, grinding, soldering, thawing pipe, torch-applied roofing, and chemical welding.
Project*
Your Cell Phone Number *
So we can text you when permit is approved/rejected Format: (000) 000-0000.
Email (copy of final permit will be sent here) *
example@example.com
Date*

MonthDayYear
Date
Company*
Time Work Starts *

(When the work commences)

AM/PM Option
Time Work is Completed *

(When the work is complete)

AM/PM Option
Fire Watch Time Completed*

(When Fire Watch is over)

AM/PM Option
Location/Building/Floor*
Work to be done*
THIS PERMIT IS GOOD FOR 24 HOURS
YesN/A
YesN/A
Requirements within 50 ft. (15 m) of hot work:
YesN/A
YesN/A
YesN/A
YesN/A
YesN/A
YesN/A
YesN/A
YesN/A
Requirements for hot work on walls, ceilings, or roofs.
YesN/A
YesN/A
Requirements for hot work on enclosed equipment:
YesN/A
YesN/A
YesN/A
Requirements for hot-work fire watch and fire monitoring:
YesN/A
YesN/A
YesN/A
YesN/A
- will take place after 4 hours, or- will involve a comprehensive inspection including the use of thermal scanning after the 60 minute fire watch
Please take a photo of workspace or anything relevant to your task
Please take a second photo of your workspace if necessary
Supervisor Authorizing Hot Work:*

First NameLast Name
Supervisor Authorizing Hot Work Signature*

Clear
Permit Authorizing Individual (This will generally be a PCL representative)

First NameLast Name
Permit Authorizing Individual (PAI) Signature

Clear
Fire Watch Name*

First NameLast Name
Fire Watch Signature*

Clear
I verify that the above location has been examined, the precautions marked on the checklist above have been taken, and permission is granted for this work.
Should be Empty:

Hot Work Permit

Seek an alternative / safer method if possible!

Requirements within 50 ft. (15 m) of hot work:

Requirements for hot work on walls, ceilings, or roofs.

Requirements for hot work on enclosed equipment:

Requirements for hot-work fire watch and fire monitoring: