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Hot Work Permit

This document provides a hot work permit template to ensure safety protocols are followed for any hot work. The multi-page permit template includes sections for project details, checks for combustible materials and ventilation, equipment checks, and sign offs.

Uploaded by

Omkar Mishra
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© © All Rights Reserved
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215 views5 pages

Hot Work Permit

This document provides a hot work permit template to ensure safety protocols are followed for any hot work. The multi-page permit template includes sections for project details, checks for combustible materials and ventilation, equipment checks, and sign offs.

Uploaded by

Omkar Mishra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 5

Reliance Project Management System RPMS-HSEF-FMT-HC-083

Hot Work Permit Date:04/05/2018, Rev. 1

RECORD OF REVISIONS

Date Revision Details Revision Checked Approved


Number By By
24.06.2013 Issued for Approval 0
04.05.2018 Issued for Approval 1 Sudhir James
Mishra Thorn
Reliance Project Management System RPMS-HSEF-FMT-HC-083
Hot Work Permit Date:04/05/2018, Rev. 1

Project Name: Date:


Start Time: Time Valid to:
Issued to: Area:
Equipment No.: WO No.:
Equipment Description:
Describe work to be done:

Yes No
Yes No
Energy sources locked, tagged, Supervisor has reviewed
tried responsibilities
Radiation shutter locked with fire watch/standby
closed person
Sewers, manholes covered, Combustible materials
closed, or plugged removed
LEL monitors provided Proper fire extinguisher
available
Running
LEL % at Hrs.
water/tarps/blankets
LEL % at Hrs. Signs and barricades
posted
LEL % at Hrs. Vehicle entry
LEL % at Hrs. Fire watch/standby person
name:
Signs and barricades
If LEL >0 Do Not Proceed ,
posted
notify to supervisor and HSE
Representative
Hoses/torches/welding Proper means of exit /
equipment in good condition escape provided
Compressed gas/LPG cylinders Service piping/electrical
properly located/secured systems protected

Hot Work Permit (RPMS-HSEF-FMT-HC-83 ) Page 3 of 5


© 2018 Reliance Industries Ltd.
Reliance Project Management System RPMS-HSEF-FMT-HC-083
Hot Work Permit Date:04/05/2018, Rev. 1

Proper electrical STA Conducted


connections/grounding for
welders
High-temperature/high- Other:
pressure hazards controlled
Proper ventilation and Lighting Other:
providing

Conditions not all met:

Special procedure prepared:

Protective equipment:
Fire resistance Rubber Boot,Safety Chemical Gloves
clothing Shoes
Goggles Acid Hood Full Acid Suit
Hearing Breathing Air Slicker Suit
Protection
Cartridge Respirator Others
Face Shield

Permit to Work Issuer


Issuer Name Signature Date Time Contact No

Acceptance
This permit is only valid when above parts have been completed.

Supervisor and Hot Signature Organization Date Contact No


Work Personnel Name

Hot Work Permit (RPMS-HSEF-FMT-HC-83 ) Page 4 of 5


© 2018 Reliance Industries Ltd.
Reliance Project Management System RPMS-HSEF-FMT-HC-083
Hot Work Permit Date:04/05/2018, Rev. 1

Turn back to Issuer:


Work is not completed: Date Time Hrs
Status:

Yes No
Yes No
Work is completed Work area has been cleaned
Tools and equipment have Tags and locks have been
been put away removed
Supervisor Name Signature Date Time

Issuer Name Signature Date Time

Note: This form is referenced in Procedure RPMS-HSEF-PRA-HC-046

Hot Work Permit (RPMS-HSEF-FMT-HC-83 ) Page 5 of 5


© 2018 Reliance Industries Ltd.

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