Moss

HOT WORK PERMIT

BEFORE INITIATING HOT WORK, ENSURE PRECAUTIONS ARE IN PLACE! MAKE SURE AN APPROPRIATE FIRE EXTINGUISHER IS READILY AVAILABLE!

This Hot Work Permit is required for any operation involving open flames or producing heat and /or sparks. This includes, but is not limited to: Brazing, Cutting, Grinding, Soldering, Thawing Pipe, Torch-Applied Roofing, and Cad welding.

A. Verify precautions listed at right (or do not proceed with the work).

B. Complete and retain this permit.

DATE

PROJECT NAME(Job Site)

HOT WORK BEING DONE BY:

SUBCONTRACTOR (Company)

LOCATION/BUILDING & FLOOR

NATURE OF JOB/OBJECT

NAME OF PERSON DOING HOT WORK

I verify the above location has been examined, the precautions checked on the Required Precautions Checklist have been taken to prevent fire, and permission is authorized for work.

NAME AND SIGNATURE HOT WORK SUPERVISOR

Clear Signature

PERMIT EXPIRES

DATE TIME AM / PM

I verify the above location has been examined, the location has been "cooled down" prior to vacating the permitted area.

Person Issuing Authority(PIA) SIGNATURE:

Clear Signature

Cancel

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HOT WORK PERMIT

BEFORE INITIATING HOT WORK, ENSURE PRECAUTIONS ARE IN PLACE! MAKE SURE AN APPROPRIATE FIRE EXTINGUISHER IS READILY AVAILABLE!

INSTRUCTION

THIS PERMIT IS GOOD FOR ONE DAY ONLY!

REQUIRED PRECAUTIONS CHECKLIST

HOT WORK PERMIT

BEFORE INITIATING HOT WORK, ENSURE PRECAUTIONS ARE IN PLACE! MAKE SURE AN APPROPRIATE FIRE EXTINGUISHER IS READILY AVAILABLE!

INSTRUCTION

THIS PERMIT IS GOOD FOR ONE DAY ONLY!

REQUIRED PRECAUTIONS CHECKLIST

Information