Applegreen Electric – Hot Work Permit

Project Name

Date*

Organization Name*

Supervisor for the Hot work*

Emergency Contact Number*

Description of work*

Equipment to be used*

The exact location of the Hot work*

Number of persons involved in the work*

Other arrangement, if needed, please specify below

I have personally checked the above precautions and consider it safe to carry out the work under the conditions outlined above. This is to certify that I authorise the hot work to proceed: Name:*

The person carrying out fire watch*

This work session is/is not (delete as appropriate) completed.

I have tidied and safely stored tools and materials.
The work area has been cleaned and waste has been correctly disposed of, the fire officer (or similar person) has been informed to reactivate isolated detectors. Fire Watch will remain in position for 1 Hour.
The above work is completed and all flame and spark producing equipment has been removed from the Permit area.
The area has been checked for smouldering or burning smells at 30 Minutes and again at 1 hour by fire watch

Name*

Date of cancellation or closing of the permit*

Verification

Permit Issuer

Permit Receiver

Completed Sign-Off

Permit Issuer

Permit Receiver

Applegreen Electric - Hot Work Permit

This work session is/is not (delete as appropriate) completed.

Verification

Completed Sign-Off