APPENDIX_V_Fillable_Hot_Work_Permit.pdf

Hot Work Record Record ID: Record Created By:

Section 1: Permit Details

Operator Organization: Organization Phone Number:

Operator Name: Operator Phone Number:

Operator Command:

Issue Date / Time: Expiration Date / Time:

Installation:

Building: Floor Number:

Issuer: Log Date:

Command: Department:

Section 2: Operation Details

Open Area Location / Description:

Operation Type: Operation Type Cont. Military Specific Equipment Type: (Select only one)

Brazing Occupancy Changes Afloat Asset

Coffe/Break Area Open Flame Aircraft Carrier

Cooking Other Airplane

Cutting Power Hand Tools Battleship

Cutting and Welding Soldering Helicopter

Drilling Tar Kettle Other

Fireworks Torching Ship

Fueling Welding Structure

Grinding Submarine

Heating Vehicle

Equipment Identification Number:

Operation Description / Notes:

Section 3: Special Requirements

Emergency Shutdown: No

Reason for Emergency Shutdown:

Fire Watch was required during operation and a period of time thereafter.

After Operation Inspection was required.

Special Precautions:

After Operation Inspection performed and area declared safe. Date:

After Operation Inspector:

Operator / Fire Watch declared the area safe. Date:

Name of Caller: Organization of Caller: