1. Project Information: (To be filled by initiator/originator) Project Name: Permit No.: Project Location: Requesting Contractor/Company 2. Permit Issuance Details: (To be filled by initiator/originator) THIS PERMIT IS ONLY FOR ONE SHIFT AND NOT EXTENDABLE Description of Task: Detail of Surroundings: Permit Validity: Time (from): __________Hrs. Time (To): __________Hrs. Date: 3. Hot Work Details: (To be filled by initiator/originator) Hot Work Operator Contact: Fire Watcher Contact: Type of Hot Work: ☐ Welding ☐ Oxy Acetylene ☐ Electric Arc ☐ Gas Cutting ☐ Oxy Acetylene ☐ LPG ☐ Grinding : ☐ Disc Cutting: ☐ Other: Fire Fighting Equipment Required: ☐ Fire Extinguisher: ☐ Hose Reel: ☐ Fire Blanket: ☐ Water: ☐ Sand: ☐ Other(s): Specific PPEs Required: ☐ Hearing Protection: ☐ Ear Plug ☐ Ear Muff ☐ Face Shield/ Visor: ☐ Welding Suit: ☐ Gloves (Type): ☐ Dark welding goggles with appropriate lens number: ____________ ☐ Mask ☐ Dust ☐ Chemical ☐ Respirator ☐ Safety Boots: ☐ Full Body Harness: ☐ Apron: ☐ Others: __________________ 4. Prerequisites: (To be filled by initiator/originator and verified by Evaluator) Checks Yes-No-NA Checks Yes-No-NA Risk assessment/ method statement developed, approved and communicated? ☐ ☐ ☐ Arc welding machine is in good condition ☐ ☐ ☐ Operator is competent and certified ☐ ☐ ☐ welding cable, connector, clamp and rod holder are in good condition ☐ ☐ ☐ Stand-by fire watcher is trained & competent ☐ ☐ ☐ Cutting/Grinding machine discs fitted with guards ☐ ☐ ☐ Area immediately below the wok spot is cleared from all Combustible materials ☐ ☐ ☐ Power tools monthly inspection done and color coded ☐ ☐ ☐ All flammable materials/chemical cleared from the hot work area ☐ ☐ ☐ Power tools accessories available & in good condition (key, extension cord, sockets etc.) ☐ ☐ ☐ Firefighting equipment available at welding area ☐ ☐ ☐ Environmental aspect, impacts and control measures are in place ☐ ☐ ☐ Tin sheet/Fire blanket are provided to prevent sparks from spreading ☐ ☐ ☐ Provision of vigilance supervision ☐ ☐ ☐ Welding Area screening done to prevent UV rays ☐ ☐ ☐ Safe means of access/egress provided? ☐ ☐ ☐ Flask back arrester installed to the gas cylinders ☐ ☐ ☐ Proper barricade and signage are posted? ☐ ☐ ☐ Gas cylinders and fittings are free from cracks, grease etc. ☐ ☐ ☐ Is confined space PTW required & obtained? ☐ ☐ ☐ Gas cylinders are kept upright and secured ☐ ☐ ☐ Other(s) if Any ☐ ☐ ☐ 5. Acknowledgement by Initiator and Evaluator: ☐ Acknowledge that all above precautions have been taken. These have also been fully explained to the operatives, and I consider them competent to do it safely. Initiator/Originator Name: Designation: Signature: Date /Time: ☐ Acknowledge that I have checked above control

1. HOT WORK PERMIT
Page 1 of 2 Form # HSEQ – HWP (Rev 7 - Mar 23)
1. Project Information: (To be filled by initiator/originator)
Project Name: Permit No.:
Project Location:
Requesting Contractor/Company
2. Permit Issuance Details: (To be filled by initiator/originator)
THIS PERMIT IS ONLY FOR ONE SHIFT AND NOT EXTENDABLE
Description of Task:
Detail of Surroundings:
Permit Validity: Time (from): __________Hrs. Time (To): __________Hrs. Date:
3. Hot Work Details: (To be filled by initiator/originator)
Hot Work Operator Contact:
Fire Watcher Contact:
Type of Hot Work: ☐ Welding
☐ Oxy Acetylene ☐ Electric Arc
☐ Gas Cutting
☐ Oxy Acetylene ☐ LPG
☐ Grinding :
☐ Disc Cutting:
☐ Other:
Fire Fighting Equipment
Required:
☐ Fire Extinguisher:
☐ Hose Reel:
☐ Fire Blanket:
☐ Water:
☐ Sand:
☐ Other(s):
Specific PPEs Required: ☐ Hearing Protection:
☐ Ear Plug ☐ Ear Muff
☐ Face Shield/ Visor:
☐ Welding Suit:
☐ Gloves (Type):
☐ Dark welding goggles with
appropriate lens number: ____________
☐ Mask
☐ Dust ☐ Chemical ☐ Respirator
☐ Safety Boots:
☐ Full Body Harness:
☐ Apron:
☐ Others: __________________
4. Prerequisites: (To be filled by initiator/originator and verified by Evaluator)
Checks Yes-No-NA Checks Yes-No-NA
Risk assessment/ method statement developed,
approved and communicated?
☐ ☐ ☐ Arc welding machine is in good condition ☐ ☐ ☐
Operator is competent and certified ☐ ☐ ☐
welding cable, connector, clamp and rod
holder are in good condition
☐ ☐ ☐
Stand-by fire watcher is trained & competent ☐ ☐ ☐
Cutting/Grinding machine discs fitted with
guards
☐ ☐ ☐

2. HOT WORK PERMIT
Page 2 of 2 Form # HSEQ – HWP (Rev 7 - Mar 23)
Area immediately below the wok spot is cleared
from all Combustible materials
☐ ☐ ☐
Power tools monthly inspection done and
color coded
☐ ☐ ☐
All flammable materials/chemical cleared from
the hot work area
☐ ☐ ☐
Power tools accessories available & in good
condition (key, extension cord, sockets etc.)
☐ ☐ ☐
Firefighting equipment available at welding
area
☐ ☐ ☐
Environmental aspect, impacts and control
measures are in place
☐ ☐ ☐
Tin sheet/Fire blanket are provided to prevent
sparks from spreading
☐ ☐ ☐ Provision of vigilance supervision ☐ ☐ ☐
Welding Area screening done to prevent UV
rays
☐ ☐ ☐ Safe means of access/egress provided? ☐ ☐ ☐
Flask back arrester installed to the gas cylinders ☐ ☐ ☐ Proper barricade and signage are posted? ☐ ☐ ☐
Gas cylinders and fittings are free from cracks,
grease etc.
☐ ☐ ☐
Is confined space PTW required &
obtained?
☐ ☐ ☐
Gas cylinders are kept upright and secured ☐ ☐ ☐
Other(s) if Any
☐ ☐ ☐
5. Acknowledgement by Initiator and Evaluator:
☐ Acknowledge that all above precautions have been taken. These have also been fully explained to the operatives,
and I consider them competent to do it safely.
Initiator/Originator
Name:
Designation:
Signature: Date /Time:
☐ Acknowledge that I have checked above control measures and consider the work area safe to carry out the activity
Evaluator (HSE Team): Designation:
Signature: Date /Time
Comments (if any):
6. Authorization (PM/CM):
Name: Designation:
Signature: Date /Time:
7. Completion of Work:
☐ Acknowledge that the area have been restored to a safe and orderly condition.
Initiator Signature: Time:
☐ Acknowledge that I have checked the area and been restored to a safe and orderly condition.
Evaluator Signature: Time:
8. REINSPECTION OF HOTWORK AREA AFTER ONE HOUR OF WORK COMPLETED:
☐ Acknowledge that the work is completed and area cleared.
Initiator Signature: Time:
☐ Acknowledge that the area is in safe and orderly condition.
Evaluator Signature: Time: