Hot Work Permit Tag, Hot Work Permit, Paper, 5 3/4 in H x 3 3/16 in W, White, Rectangle, 25 PK

The supervisor, in issuing this permit, certifies that all safety factors have been considered and cared for satisfactorily. Return this permit upon completion of the job which it is to cover to the authorizing supervisor. The supervisor will write "complete", date and initial across the face of the permit. Area of Hot Work__Work to Be Done__Other Side Must Be Filled Out! Approval. I have personally checked the conditions necessary and as specified, I authorize this "Hot" work to being. Approved By__Date__Time__How Work Permit Is Good For__Hours Only. This permit can be issued for only one shift. It becomes void at the end of work shift day.

1. Read The Hot Work Permit Procedure. Yes__No__N/A__ 2. Work area and equipment has been made free of flammable, combustible, and hazardous materials. 3. Gas test taken. 4. Is a fire extinguisher on the job? 5. Smoke alarms covered? 6. Lines disconnected and/or blanked? 7. Is fire watch provided? 8. Adjoining equipment and operations considered ok from standpoint of possible effect on the job. 9. Other necessary precautions. Specify. See Other Side! This permit can be issued for only one shift. It becomes void at the end of work shift day.

Hot Work Permit, The Supervisor,In Issuing This Permit ,Certifies That All Safety Factors Have Been Considered And Cared For Satisfactorily. Return This Permit Upon Completion Of The Job Which It Is To Cover To The Authorizing Supervior. The Supervior Will Write "Complete",Date And Initial Across The Face Of The Permit. Area Of Hot Work_Work To Be Done__ Approval In This Attribute