London's Royal Docks Hot Works Permit

Hot-work permits are required for any operation involving open flames or producing heat and/or sparks and must be prepared by a competent person. Hot works include brazing, torch cutting, grinding, soldering and welding.

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Company Name
Project Title
Location
Permit number
Contractor
Supervisor Supervisor First Last
Equipment to be used.
Date of works Date of works / DD / MM YYYY
Start Time Start Time : HH MM AM/PM
Finish Time Finish Time : HH MM AM/PM

Operatives carrying out hot works must:
Operatives carrying out hot works must:	Yes	No	N/A
understand the permit conditions and the fire and safety precautions	understand the permit conditions and the fire and safety precautionsYes	understand the permit conditions and the fire and safety precautionsNo	understand the permit conditions and the fire and safety precautionsN/A
be in possession of a permit at all times	be in possession of a permit at all timesYes	be in possession of a permit at all timesNo	be in possession of a permit at all timesN/A
stop work if required to do so by an authorised person	stop work if required to do so by an authorised personYes	stop work if required to do so by an authorised personNo	stop work if required to do so by an authorised personN/A
immediately report any hazard likely to affect the fire and safety precautions	immediately report any hazard likely to affect the fire and safety precautionsYes	immediately report any hazard likely to affect the fire and safety precautionsNo	immediately report any hazard likely to affect the fire and safety precautionsN/A
ensure satisfactory access to and egress from the work area.	ensure satisfactory access to and egress from the work area.Yes	ensure satisfactory access to and egress from the work area.No	ensure satisfactory access to and egress from the work area.N/A

Confirmation by contractor’s supervisor: I confirm that the precautions specified above will be complied with and I will ensure that the persons carrying out the work described above are fully briefed on the safe method of work. Confirmation by contractor’s supervisor: I confirm that the precautions specified above will be complied with and I will ensure that the persons carrying out the work described above are fully briefed on the safe method of work. First Last
Position
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY
Confirmation by operator: I understand the precautions to be taken in carrying out the hot works. Confirmation by operator: I understand the precautions to be taken in carrying out the hot works. First Last
Position
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY
Site management authorisation: I certify that the above work can commence with the precautions listed above. Site management authorisation: I certify that the above work can commence with the precautions listed above. First Last
Positon
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / DD / MM YYYY

Precautions to be taken.	Yes	No	N/A
Hot work must cease at least one hour before end of shift. Areas where hot works have been carried out should be checked before leaving site.	Hot work must cease at least one hour before end of shift. Areas where hot works have been carried out should be checked before leaving site.Yes	Hot work must cease at least one hour before end of shift. Areas where hot works have been carried out should be checked before leaving site.No	Hot work must cease at least one hour before end of shift. Areas where hot works have been carried out should be checked before leaving site.N/A
Services affected must be isolated before work commences.	Services affected must be isolated before work commences.Yes	Services affected must be isolated before work commences.No	Services affected must be isolated before work commences.N/A
Isolate smoke detectors in the vicinity of hot works.	Isolate smoke detectors in the vicinity of hot works.Yes	Isolate smoke detectors in the vicinity of hot works.No	Isolate smoke detectors in the vicinity of hot works.N/A
A suitable fire extinguisher must be available and be kept close at hand, at all times.	A suitable fire extinguisher must be available and be kept close at hand, at all times.Yes	A suitable fire extinguisher must be available and be kept close at hand, at all times.No	A suitable fire extinguisher must be available and be kept close at hand, at all times.N/A
Supervisors must ensure suitable personal protective equipment (PPE) is provided and worn by operatives.	Supervisors must ensure suitable personal protective equipment (PPE) is provided and worn by operatives.Yes	Supervisors must ensure suitable personal protective equipment (PPE) is provided and worn by operatives.No	Supervisors must ensure suitable personal protective equipment (PPE) is provided and worn by operatives.N/A
All cylinders must be transported and secured upright.	All cylinders must be transported and secured upright.Yes	All cylinders must be transported and secured upright.No	All cylinders must be transported and secured upright.N/A
Valves and hoses must be in good condition.	Valves and hoses must be in good condition.Yes	Valves and hoses must be in good condition.No	Valves and hoses must be in good condition.N/A
All cylinders must have flashback arrestors fitted.	All cylinders must have flashback arrestors fitted.Yes	All cylinders must have flashback arrestors fitted.No	All cylinders must have flashback arrestors fitted.N/A
When not in use, cylinders must be shut off and returned to store.	When not in use, cylinders must be shut off and returned to store.Yes	When not in use, cylinders must be shut off and returned to store.No	When not in use, cylinders must be shut off and returned to store.N/A
LPG cylinders must not be left in the building overnight without formal approval.	LPG cylinders must not be left in the building overnight without formal approval.Yes	LPG cylinders must not be left in the building overnight without formal approval.No	LPG cylinders must not be left in the building overnight without formal approval.N/A
Arc welding equipment will comply with current standards.	Arc welding equipment will comply with current standards.Yes	Arc welding equipment will comply with current standards.No	Arc welding equipment will comply with current standards.N/A
Spent welding rods must be immersed in a bucket of water.	Spent welding rods must be immersed in a bucket of water.Yes	Spent welding rods must be immersed in a bucket of water.No	Spent welding rods must be immersed in a bucket of water.N/A
Minimum radius of hot work must be 2 m from other persons working. Screens should be erected if needed.	Minimum radius of hot work must be 2 m from other persons working. Screens should be erected if needed.Yes	Minimum radius of hot work must be 2 m from other persons working. Screens should be erected if needed.No	Minimum radius of hot work must be 2 m from other persons working. Screens should be erected if needed.N/A
Where hot works are required adjacent to combustible material, a fireproof protective mat should be placed between the material and the heat source during the hot works. (Check both sides of partition walls to ensure that heat has not been transferred by conduction to combustible materials.)	Where hot works are required adjacent to combustible material, a fireproof protective mat should be placed between the material and the heat source during the hot works. (Check both sides of partition walls to ensure that heat has not been transferred by conduction to combustible materials.)Yes	Where hot works are required adjacent to combustible material, a fireproof protective mat should be placed between the material and the heat source during the hot works. (Check both sides of partition walls to ensure that heat has not been transferred by conduction to combustible materials.)No	Where hot works are required adjacent to combustible material, a fireproof protective mat should be placed between the material and the heat source during the hot works. (Check both sides of partition walls to ensure that heat has not been transferred by conduction to combustible materials.)N/A
Work areas to be kept tidy and free from combustible materials.	Work areas to be kept tidy and free from combustible materials.Yes	Work areas to be kept tidy and free from combustible materials.No	Work areas to be kept tidy and free from combustible materials.N/A
When operatives are working in riser shafts or on staging with cylinders, work will be secured and openings to other levels covered with a fire blanket or other non-combustible materials.	When operatives are working in riser shafts or on staging with cylinders, work will be secured and openings to other levels covered with a fire blanket or other non-combustible materials.Yes	When operatives are working in riser shafts or on staging with cylinders, work will be secured and openings to other levels covered with a fire blanket or other non-combustible materials.No	When operatives are working in riser shafts or on staging with cylinders, work will be secured and openings to other levels covered with a fire blanket or other non-combustible materials.N/A
Operatives must remain in the area for 15 minutes after completing work to ensure there is no hot-spot residue.	Operatives must remain in the area for 15 minutes after completing work to ensure there is no hot-spot residue.Yes	Operatives must remain in the area for 15 minutes after completing work to ensure there is no hot-spot residue.No	Operatives must remain in the area for 15 minutes after completing work to ensure there is no hot-spot residue.N/A