HOT WORK PERMIT

All temporary operations involving open flames or producing heat and/or sparks require
a Hot Work Permit. This includes, but is not limited to, Brazing, Cutting, Grinding,
Soldering, Thawing, and Welding.

PART A
INSTRUCTIONS FOR FIRE HOT WORK CHECKLIST
SAFETY SUPERVISOR Sprinklers and hose streams in service/operable.
1. Verify precautions listed at right (or do not Hot Work Equipment in good condition (e.g., power
proceed with the work). source, welding leads, torches, etc.)
2. Complete PLY 1 and retain for job files. Multi-purpose fire extinguisher and/or water pump can.
3. Post PLY 2 in vicinity of hot work.
REQUIREMENTS WITHIN 35 FEET OF WORK
DATE JOB NO. Dust, Lint, Debris, Flammable Liquids and oily
deposits removed.
LOCATION/BUILDING & FLOOR (Be Specific) Explosive atmosphere in area eliminated.
Combustible floors (e.g., wood, tile, carpeting) wet
down, covered with damp sand or fire blankets.
DESCRIPTION OF WORK BEING PERFORMED
Remove flammable and combustible material where
possible. Otherwise protect with fire blankets, guards,
NAME OF PERSON DOING HOT WORK or metal shields.
All wall and floor openings covered.
The above location has been examined, the precautions Walkways protected beneath hot work.
checked on the Hot Work Checklist have been taken to
WORK ON WALLS OR CEILINGS
prevent fire, and permission is authorized for this work.
Combustibles moved away from other side of wall.
SIGNED: WORK IN CONFINED SPACES
(Fire Safety Supervisor)
Confined space cleaned of all combustibles
(example: grease, oil, flammable vapors).
SIGNED:
(Person doing Hot Work) Containers purged of flammable liquids/vapors.
Follow confined space guidelines.
SIGNED:
(Fire Watch) FIRE WATCH/HOT WORK AREA MONITORING
Fire watch will be provided during and for 30 minutes
TIME
after work, including any coffee or lunch breaks.
STARTED: Date: Time: AM/PM
Fire watch is supplied with an extinguisher, and/or
PERMIT water pump can, also making use of other
EXPIRES: Date: Time: AM/PM extinguishers located throughout work area.
Fire watch is trained in use of this equipment and
familiar with location of sounding alarm.
Fire watch may be required for opposite side of walls,
above, and below floors and ceilings.

OTHER PRECAUTIONS TAKEN

FILL OUT EMERGENCY INFORMATION ON PAGE 2.

© Copyright J.J. Keller & Associates, Inc Neenah, WI USA (800) 327-6868
 HOT WORK PERMIT
All temporary operations involving open flames or producing heat and/or sparks require
a Hot Work Permit. This includes, but is not limited to, Brazing, Cutting, Grinding,
Soldering, Thawing, and Welding.

PART B
INSTRUCTIONS FOR FIRE HOT WORK CHECKLIST
SAFETY SUPERVISOR Sprinklers and hose streams in service/operable.
1. Verify precautions listed at right (or do not Hot Work Equipment in good condition (e.g., power
proceed with the work). source, welding leads, torches, etc.)
2. Complete page 1 and retain for job files. Multi-purpose fire extinguisher and/or water pump can.
3. Post page 2 in vicinity of hot work.
REQUIREMENTS WITHIN 35 FEET OF WORK
DATE JOB NO. Dust, Lint, Debris, Flammable Liquids and oily
deposits removed.
LOCATION/BUILDING & FLOOR (Be Specific) Explosive atmosphere in area eliminated.
Combustible floors (e.g., wood, tile, carpeting) wet
down, covered with damp sand or fire blankets.
DESCRIPTION OF WORK BEING PERFORMED
Remove flammable and combustible material where
possible. Otherwise protect with fire blankets, guards,
NAME OF PERSON DOING HOT WORK or metal shields.
All wall and floor openings covered.
The above location has been examined, the precautions Walkways protected beneath hot work.
checked on the Hot Work Checklist have been taken to
WORK ON WALLS OR CEILINGS
prevent fire, and permission is authorized for this work.
Combustibles moved away from other side of wall.
SIGNED: WORK IN CONFINED SPACES
(Fire Safety Supervisor)
Confined space cleaned of all combustibles
(example: grease, oil, flammable vapors).
SIGNED:
(Person doing Hot Work) Containers purged of flammable liquids/vapors.
Follow confined space guidelines.
SIGNED:
(Fire Watch) FIRE WATCH/HOT WORK AREA MONITORING
Fire watch will be provided during and for 30 minutes
TIME
after work, including any coffee or lunch breaks.
STARTED: Date: Time: AM/PM
Fire watch is supplied with an extinguisher, and/or
PERMIT water pump can, also making use of other
EXPIRES: Date: Time: AM/PM extinguishers located throughout work area.
FIRE WATCH SIGNOFF Fire watch is trained in use of this equipment and
familiar with location of sounding alarm.
Work area and all adjacent areas to which sparks and Fire watch may be required for opposite side of walls,
heat might have spread were inspected during the fire above, and below floors and ceilings.
watch period and were found fire safe.
OTHER PRECAUTIONS TAKEN
Signed:

FINAL CHECKUP (minimum 30 minutes after Hot Work)

Work area was monitored for hour(s) following Hot

Work and found fire safe.
Signed:
FILL OUT EMERGENCY INFORMATION ON BACK OF PLY 2.

© Copyright J.J. Keller & Associates, Inc Neenah, WI USA (800) 327-6868
WARNING!
HOT WORK IN PROGRESS
WATCH FOR FIRE!
IN CASE OF AN EMERGENCY:

CALL:

AT:

WARNING!