Hot Work - Permit To Work

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HOT WORK PERMIT

Permit No.: HW Project Title SHARJAH WATERFRONT CITY

PERMIT REQUIRED FOR LOCATION: SECTOR / 2 / YARD AREA

Section – I CONTACT DETAILS


Task Supervisor/Foreman Contact Number
Engineer Responsible Contact Number
Safety Officer on Site Chima Elvis Contact Number
Section – II PERMIT VALIDATIONS
THIS PERMIT IS VALID FOR MAXIMUM
PERMIT ISSUE DETAILS
Date ____________________ Time ________________ OF 12 HOURS ONLY. PERMIT SHOULD
BE RENEWED IF SHIFT CHANGES.
NO EXTENSION WILL BE GIVEN ON THIS
PERMIT EXPIRY DETAILS
Date ____________________ Time ________________ PERMIT

THIS PERMIT IS ONLY TO BE USED BY THE PERSONS TO WHOM IT IS ISSUED. ON COMPLETION OF THE TASK OR ON EXPIRY THE
PERMIT IS TO BE RETURNED TO THE ISSUER FOR CANCELATION

Section – III REQUIREMENTS (Work May not commence if one of the following is not complied with)
Y/
 for YES and X for No Y/N NA  for YES and X for No N
NA

Has proper housekeeping been conducted and


Is there proper ventilation / air flow in the
A all combustible materials been removed within F
work area?
15m from work area?
Have the operatives been trained to carry out Has atmosphere been tested for
B G
this activity? combustible/toxic vapours/gases?
Have all tools to be used for this activity been
C inspected and ensured to be safe and in good H
working condition?
D Do the operatives have the task specific PPE? I

Are fire fighting equipment located within 5m


E J
from work area?

Section - IV Briefing / Tool Box Talks Attendance


NAME SIGN NAME SIGN
1 6
2 7
3 8
4 9
5 10
DECLARATIONS COMMENTS BY HSE

We ensure that the precautions checked and/or written above have been
taken and will be followed throughout the duration of the job.
Permit Issuer (Engineer):
Name /Sign………………………………..…….. Date/Time:…………………..
Permit must be closed after completion of the activity or at the end
of the shift and should be submitted to HSE office.
Permit Receiver (Task Supervisor / Foreman):
Closed / Cancelled by:……………………………... Time:
Name /Sign……………………………… ………Date/Time…………………… ……………. Reason:…………………………
PERMIT COPY DISTRIBUTION (tick appropriate boxes):
Project Construction Project
HSE Personnel (HP) Job area
Manager(PM) Manager(CM) Engineer

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