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Permit #:
Hot Work Permit
Any personnel performing hot work outside the maintenance or welding area must be authorized. An Analysis of
Risk or Job Safety Analysis (JSA) must be carried out, and appropriate controls put in place before the work starts.
Are the people trained to perform hot work? Yes No
Has a trained and competent person been appointed to be on standby? If No
Section 1 - Work Specification
Location of the Work Area:
Job Description
Duration of Work: Start date/time / / .......hrs End date/time / / .......hrs
Section 2 – Control Measures
Is fire watch required? Yes No When yes, indicate the appropriate monitoring intervals.
Continue With intervals With intervals after completing the work
(Name the people below) (up to 4 hours)
Verification of Fire Watches – Firm ONLY after completing your watch
Nombre Fecha Company
The permit cannot be canceled until the inspections have been completed.
Has the area been checked for flammable gases? Yes No % Resulting Level
Acceptance levels: Oxygen >19% and <24%, Sulfuric Acid <0.1ppm y CO2 <0.5%
Nombre: Company: Date: / /
Section 3 – Work Authorization
I accept this permission, I accept the obligations of the aforementioned conditions associated with this procedure, I accept the responsibility.
as the direct person in charge of the work. I have read the risk analyses, the Job Safety Analyses, the procedures and rescue plan and
I will ensure that the risk controls are implemented.
Work Manager Company Date / /
The work described above must be authorized by the appropriate supervisor (or their representative) who is responsible for overseeing the work and only
It will be done when the responsible persons have approved all the authorizations.
DPW Supervisor Company Date / /
DPW Manager Company Date / /
Sección 4 – Finalización, Suspensión o Cancelación del Trabajo Please mark the appropriate answer.
All work associated with this work permit has been Completado Cancelado Suspended
The work area and adjacent areas have been inspected after the end of the
Yes No
work and all dangers insured:
The work area and adjacent areas have been inspected during the duration of a Surveillance.
If No
at least 30 minutes after completing the work.
The equipment has been inspected and rebooted correctly. If No
Additional Comments: .............................................................................................................................................
.......................................................................................................................................................................................
DPW representative: Company: Date: Hour:
Document Reference: SI-02-004 ID Registro: SI-02-004-07
No. Review: N/A
Fecha Efectiva: 19/03/09
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Checklist - These points should be considered as part of the Answers Action
Risk Analysis / Job Safety Analysis
Is the portable fire extinguisher available? Yes No
Are there hoses and water available? If No
Have combustible materials been removed within an 11-meter radius of the work? Yes No
The fire protection requirements, localization and have been determined.
the conditions?
Yes No
Is it necessary to isolate fixed fire protection systems? If No
Have electrical or gas pipes been removed from the work area? If No
Have recoil regulators been placed at both hose inlets? Yes No
Is fireproof bedding required? If No
Is gas detection equipment needed? Yes No
Is the area below and above the work clean/ready? Yes No
Are fans/ventilators required due to the gases? Yes No
Will this work create another danger in another work area? Yes No
For hot work in Confined Space - Request Confined Space Permit Yes No
Is the Emergency Response Procedure clear? Yes No
Are screens/netting installed to control sparks? Yes No
Is the spread of hot debris, flames, or sparks under control? If No
The ends of the electrodes, cutting waste, and other debris have been placed.
In a metal container?
If No
Is notification to the Emergency Services required? Yes No
Are 'Hot Work' or 'Danger' signages needed? Yes No
Are barricades required? Yes No
Is a face shield, safety glasses, or goggles necessary? Yes No
Are leather gloves or jackets needed? Yes No
Are goggles needed for oxy-fuel cutting? If No
Is a welding helmet needed? Yes No
Are safety glasses and masks used while welding? Yes No
The floors have been cleaned, the holes filled, and the woods wet. If No
Is communication required via telephone or radio? Yes No
Additional Checks Required / Completed
Definition of Hot Work: It is a job that tends to produce ignition sources, including the
welding, gas cutting, pressure cleaning and the sparks produced by portable tools and equipment, or others
ignition source such as grinders or polishers, welding, cutting or heating with oxy/gas.
Definition of Dangerous Area: It is an area where flammable liquids, vapors, or gases, combustibles
Liquids, powder or fibers or any other flammable or explosive substance may be present.
ALL COMPLETED PERMISSIONS MUST BE STORED AT THE POINT OF ORIGIN FOR
ALLOW THE CONTROL OF THE DOCUMENT.
Document Reference: SI-02-004 ID Registro: SI-02-004-07
No. Review: N/A
Fecha Efectiva: 19/03/09
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