• Electrical Hot Work Permit

    To be completed and submitted before opening an enclosure that contains exposed energized electrical circuits.
  • Supervisor*

  • Type of Hot Work*
  • Is this permit for work that is being planned for another day or is this for emergency/service work that needs to happen immediately?*
  • Date for performance of Hot Work*
     - -
  • Will there be Non-P&S personnel on-site, that need to be inside the Arc Flash Boundary or the Limited Approach Boundary?*
  • Has the equipment shutdown/de-energized?*
  • What was done to shutdown/de-energize the equipment so that it is in an electrically safe work condition?*

  • Shock Risk Assessment

  • Limited Approach Boundary (Exposed Movable Conductor) 10 ft. 0 in.

    Limited Approach Boundary (Exposed Fixed Part)    		 3 ft. 6 in.
    Restricted Approach Boundary Avoid Contact
    Req'd Hot Glove Rating 0 Red (1000v rated)
  • Limited Approach Boundary (Exposed Movable Conductor) 10 ft. 0 in.

    Limited Approach Boundary (Exposed Fixed Part)    		 3 ft. 6 in.
    Restricted Approach Boundary 1 ft. 0 in.
    Hot Glove Rating Req'd 0 Red (1000v rated)
  • Limited Approach Boundary (Exposed Movable Conductor) 10 ft. 0 in.

    Limited Approach Boundary (Exposed Fixed Part)    		 5 ft. 0 in.
    Restricted Approach Boundary 2 ft. 2 in.
    Hot Glove Rating Req'd 2 Yellow (17,000v rated)
  • Limited Approach Boundary (Exposed Movable Conductor) 10 ft. 0 in.

    Limited Approach Boundary (Exposed Fixed Part)    		 6 ft. 0 in.
    Restricted Approach Boundary 2 ft. 9 in.
    Hot Glove Rating Req'd 4 Orange (36,000v rated)
  • Image field 275

  • Arc Flash Risk Assessment

  • Equipment*

  • Arc Flash PPE Category

  • Image field 244
  • Image field 245
  • Image field 247

  • Arc Flash Boundary

  • 19 in.

  • 3 ft.

  • 5 ft.

  • 14 ft.

  • 20 ft.

  • 40 ft.

  • Do you agree the work described above can be done safely?*
  • Should be Empty: