HOT WORK PERMIT

STOP! Avoid hot work when possible - consider using an alternative cold work method.
This Hot Work Permit is required for any temporary operation involving open flames or producing heat and/or sparks. This includes, but is not limited to brazing, cutting, grinding, soldering, torch-applied roofing and welding.

Work to be performed by:

Work to be performed by: Employee Contractor
Date Date / MM / DD YYYY
LOCATION OF WORK (BUILDING/FLOOR/OBJECT)
WORK TO BE PERFORMED
NAME OF PERSON PERFORMING HOT WORK
NAME OF PERSON PERFORMING FIRE WATCH
By entering my name below, I verify the above location has been examined, the required precautions have been taken, and permission is authorized for this work.
Required Precautions

Please check appropriate boxes below - Contact Control Center or Risk Management & Safety with any questions concerning fire protection equipment.
You certify that you have called the Control Center to verify that the fire alarm and sprinkler system in the building in which work is to be performed is functional.

You certify that you have called the Control Center to verify that the fire alarm and sprinkler system in the building in which work is to be performed is functional. Yes No
Extinguishers are in service/operable.

Extinguishers are in service/operable. Yes No
Requirements within 35 feet
Shield combustible construction and/or combustibles using appropriate fire resistant welding pads, blankets or curtains.

Shield combustible construction and/or combustibles using appropriate fire resistant welding pads, blankets or curtains. Yes No N/A
Isolate or remove potential sources of flammable gas/liquid/dust.

Isolate or remove potential sources of flammable gas/liquid/dust. Yes No N/A
Shut down ventilation

Shut down ventilation Yes No N/A
Consider second fire watch on opposite side of floor, wall, ceiling or roof when openings exist or thermally conductive materials pass through.

Consider second fire watch on opposite side of floor, wall, ceiling or roof when openings exist or thermally conductive materials pass through. Yes No N/A
Is work on a combustible building assembly or component (example - torch-applied roofing)? If yes, please provide additional required precautions below.

Is work on a combustible building assembly or component (example - torch-applied roofing)? If yes, please provide additional required precautions below. Yes No
Hot work on/in closed equipment, ductwork or piping
Isolate equipment from service.

Isolate equipment from service. Yes No N/A
Remove ignitable liquid and purge flammable gas/vapor.

Remove ignitable liquid and purge flammable gas/vapor. Yes No N/A
Prior to work, and/or during work, monitor for flammable gas/vapor.

Prior to work, and/or during work, monitor for flammable gas/vapor. Yes No N/A
Remove combustible dust/lint or other combustible materials.

Remove combustible dust/lint or other combustible materials. Yes No N/A
Is work on/in equipment with nonremovable combustible linings or
parts? If yes, provide additional required precautions below.

Is work on/in equipment with nonremovable combustible linings or
parts? If yes, provide additional required precautions below. Yes No N/A
Fire watch/Fire monitoring the hot work area
Perform continuous fire watch during hot work

Perform continuous fire watch during hot work Yes No
Perform fire watch post work for minimum of 1 hour. If circumstances dictate longer, please provide additional required precautions below

Perform fire watch post work for minimum of 1 hour. If circumstances dictate longer, please provide additional required precautions below Yes No
Perform post work fire monitoring for minimum of 3 hours. If circumstances dictate longer, please provide additional required precautions below

Perform post work fire monitoring for minimum of 3 hours. If circumstances dictate longer, please provide additional required precautions below Yes No
Additional required precautions - please list below

HOT WORK PERMIT

HOT WORK PERMIT

Required Precautions

Requirements within 35 feet

Hot work on/in closed equipment, ductwork or piping

Fire watch/Fire monitoring the hot work area