Thank you for filling the form.
Entries limit is exceeded! Please contact your administrator.
"Sorry! User can't post a new entry"
Space limit is exceeded! Please contact your administrator.
"Sorry! User can't post a new entry"
Plan is expired! Please contact your administrator.
"Sorry! User can't post a new entry"
Hot Permit to Work Checklist Form
Please fill the form below carefully
1
Step 1
2
Step 2
3
Step 3
Audit
Nature of Job/Object:
This field is required.Please enter value
Required Precautions Checklist
Available sprinklers in normal automatic mode and valve open:
Yes
No
N/A
This field is required.Please enter value
Hot Work equipment in good repair:
Yes
No
N/A
This field is required.Please enter value
Assess 35 ft radial “sphere” of work for potential fire hazards
Floors, work level and below, cleaned or protected:
Yes
No
N/A
This field is required.Please enter value
Clean horizontal surfaces (e.g. building structures, equipment, ducts, cable trays, etc.) above and below where possible:
Yes
No
N/A
This field is required.Please enter value
All other combustibles removed or shielded from sparks:
Yes
No
N/A
This field is required.Please enter value
Remove flammable liquids, dust, lint, combustible waste, oil deposits, etc., where possible:
Yes
No
N/A
This field is required.Please enter value
Next
If removal/cleaning is impractical, protect with fire-retardant covers, or shield with fire-retardant guards and/or curtains:
Yes
No
N/A
This field is required.Please enter value
Transmission or conveying of sparks to adjacent areas eliminated or protected:
Yes
No
N/A
This field is required.Please enter value
Tightly cover wall/floor openings with fire-retardant material:
Yes
No
N/A
This field is required.Please enter value
Where openings cannot be sealed, suspend fire-retardant tarpaulins to help protect areas beneath:
Yes
No
N/A
This field is required.Please enter value
Isolate or shut down fans and conveyors to prevent the capturing and conveying sparks to other areas:
Yes
No
N/A
This field is required.Please enter value
Explosive atmosphere eliminated or potential not present:
Yes
No
N/A
This field is required.Please enter value
Work on walls, ceilings or enclosed equipment
Construction materials verified as noncombustible and without combustible covering or insulation:
Yes
No
N/A
This field is required.Please enter value
Next
Previous
Combustibles on another side of walls relocated or protected:
Yes
No
N/A
This field is required.Please enter value
Enclosed equipment cleaned and protected from all combustibles:
Yes
No
N/A
This field is required.Please enter value
Containers purged of flammable liquids/vapors:
Yes
No
N/A
This field is required.Please enter value
Fire watch/hot work area monitoring requirements
Continuous fire watch provided during and for at least 30 minutes after hot work, including all breaks:
Yes
No
N/A
This field is required.Please enter value
Fire watch supplied with suitable extinguishers/hoses:
Yes
No
N/A
This field is required.Please enter value
Fire watch trained in the use of fire equipment and sounding alarm:
Yes
No
N/A
This field is required.Please enter value
Area to be monitored hourly for a minimum 6 hours after job is completed, or longer if required:
Yes
No
N/A
This field is required.Please enter value
Previous
Submit
