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Hot Work Permit

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Form: Hot Work Permit OSH

Contractor’s Name and Company

Description of Hot Work

Location of Hot Work (Campus & Block)

Checklist YES NO N/A


Appropriate extinguisher is on hand ☐ ☐ ☐
Location of nearest break-glass alarm is confirmed ☐ ☐ ☐
Location of nearest fire hose reel is confirmed ☐ ☐ ☐
Fire detection system isolation has been organised ☐ ☐ ☐
All flammable materials have been removed a minimum of ten (10) metres away ☐ ☐ ☐
Combustible materials on other side of wall removed ☐ ☐ ☐
Material that cannot be removed has been shielded ☐ ☐ ☐
Cutting / welding / grinding gear is in good order ☐ ☐ ☐
Operators are experienced ☐ ☐ ☐
All necessary personal protective equipment is on hand ☐ ☐ ☐
Ventilation is adequate ☐ ☐ ☐
Spark / flash screens in place ☐ ☐ ☐
Worksite and areas below have been fenced off ☐ ☐ ☐
Fire watch is necessary for ____________ minutes after got work ☐ ☐ ☐
Name of Contractor’s Supervisor
Date / /
Signature

NOTE: NO WORK CAN COMMENCE UNTIL PERMIT IS AUTHORISED BY SOUTH REGIONAL TAFE

OFFICE USE ONLY

Hot Work Permit Authorisation


Permit No: Permit valid from: am/pm on / / to am/pm on / /
Name of SRTAFE Contact Date / /
Signature

Completion of Work
The work has been completed as required and the area has been made safe.
Name of SRTAFE Contact Date / /
Signature

Related documents
Policy: OSH Statement of Commitment and Intent

Custodian of document: Director Corporate Services Uncontrolled when printed


South Regional TAFE OSH03 F14 Issued: 23/02/2021 PIR 5966 Printed: 23/03/2021 Page 1 of 1

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