6601085_Turtle Bay Work Permit

HOT-WORK PERMIT

Hot Work Procedure HSEOP-10-02
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.
Date*

YearMonthDay
Date
Company:*
Time Started:*

Hour Minutes

AM/PM Option
Time Completed:*

Hour Minutes

AM/PM Option
Location: *
Work to be done:*
THIS PERMIT IS GOOD FOR 24 HOURS

Review the checklist items below, and select the best answer regarding your hot-work.
YesN/A
YesN/A
Requirements within 35 ft. (11 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
YesNoN/A
Signatures
Supervisor Authorizing Hot Work Name:*
Supervisor Authorizing Hot Work Signature:*
Permit-Authorizing Individual (PAI) Name:
Fire Watch Name:*
Fire Watch Signature:*
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.
Click "Submit" to send hot work permit to Permit-Authorizing Individual (PAI) for approval/signature.
Should be Empty:

HOT-WORK PERMIT