SCS Hot Work Permit

Hot Work Permit
Job/ Location
Date of Permit

MonthDayYear
Permits expire at midnight
Valid From Date

MonthDayYear
Hot work permit only valid for seven days
Valid to Date

MonthDayYear
Hot work permit valid for only seven days
Person Requesting Permit

First NameLast Name
Location of Work:
Job and location within that job.
List name/s of Fire watch/s (Required if there are combustibles within 35 feet of hot work)
Description of work to be performed
List who is performing work
Work Area Evaluation
Will there be hot work on enclosed containers or old fuel tanks?
Containers holding flammable or combustible liquids or gases have been purged, cleaned, and filled with inert liquid or gases and tested for %LEL
%LEL Reading (at time of test)
%LEL if temperature raises by 10 degrees (warmer temps can cause increased LEL's)
Take picture of work area
Upload image of work area
Hot Work In All Areas
Person completing “Hot Work Permit” understands hazards in the hot work zone.
Flame or spark-producing equipment to be used has been inspected and found to be in good repair.
Fire extinguishing water hose is in working condition and will remain in service while this work is being done.
Portable fire extinguishers are available, are appropriate for the fire hazard, and personnel have been trained to use them.
All combustibles have been relocated 35 feet from the hot work, and the remainder protected with flame-proof curtains or covers.
All voids and openings leading to other areas (rooms, floors) have been covered.
All appropriate SOPs and good work practices are being followed.
Do you have the proper personal protective equipment including welding shields, respirators, hearing protection for the job?
The method for contacting emergency responders is in place at www.ssandt.solutions under 'Incident Management'.
IF ANY ANSWER IS NO, LIST ALTERNATIVE MEANS OF CONTROL:
Atmospheric monitoring of the work area has been performed for work activities near flammable liquids and gasses or in enclosed areas?
Record initial Atmospheric readings
Periodic atmospheric testing required for work performed near flammable liquids and gasses or in enclosed areas
Time of permit is issued

:HourMinutesAM/PM Option
Permit received by:

First NameLast Name
Signature of person receiving the hot work permit.
Job Completion Sign-Off
Work completion time

:HourMinutesAM/PM Option
The fire watch verify the area has been monitored for the absence of fire for 30 minutes after Hot work activities have ceased.
Time of final inspection

:HourMinutesAM/PM Option
Final Inspection By:

First NameLast Name
Comments or lessons learned
Signature of person performing final inspection
Construction Manager Name

First NameLast Name
Construction Manager Approval
Should be Empty:

Hot Work Permit

Work Area Evaluation

Hot Work In All Areas

Job Completion Sign-Off