HOT WORK PERMIT - Airports Company South Africa

1 HOT work PERMIT THIS HOT work PERMIT SHALL BE VALID FOR NO MORE THAN A 24 HOUR PERIOD. TO EXTEND THIS PERMIT IT must BE RENEWED EACH 24 HOUR SHIFT BY SIGNATURE OF THE RESPONSIBLE OPERATING AUTHORITY AND CANCELLED ON COMPLETION OF work Worksite: Date of issue: PERMIT no.: Contractors name: Contractors responsible person: Address: For performing the work specified for duration of this PERMIT .. Description of work : Sketch of exact location: Special instructions: Any substances hazardous to health? No Yes Requirements met? No Yes Entry PERMIT issued Number: .. Approved Contractor No Yes PERSONAL POTECTION REQUIRED EYES Goggles Shield HAND PVC Gloves Ordinary Gloves EARS Ear Protection BREATHING Canister Mask Air Supplied Respirator BODY-OTHER Safety-Harness Rubber Boots PVC Suit STANDARD CONDITOINS SPECIFIC CONDITIONS The standard conditions set out overleaf to be observed for: In addition to the general work PERMIT specific conditions, the following shall apply before work is commenced Yes or No to be written DELETE NOT APPLICABLE 1.

2 Excavations 2. Welding equipment 3. Flame cutting equipment 4. Hazardous materials 5. Compressors for breathing equipment 6. Wetting down 7. Drains 8. Fire extinguishers 9. Gas free certification 10. Entry PERMIT RE-ENDORSEMENT OF PERMIT TO BE DAILY/HOURLY 1. Gas freed or purged I. By ventilation .. II. By water flushing .. III. By steaming .. IV. By nitrogen .. V. By pigging .. 2. Gas freed certificate number 3. Other conditions RE-ENDORSEMENT OF PERMIT TO BE DAILY/HOURLY AUTHORIZATION TO CARRY OUT work I, CERTIFY THAT THE ABOVE EQUIPMENT/SITE IS SAFE TO CARRY OUT HOT work BY PERSONS SUBJECT TO THE SPECIFIED REQUIREMENTS. ISSUED BY: 1. Safety Valid from.

3 Am to ..am/pm 2. Other responsible from ..am to ..am/pm I UNDERSTAND THE NATURE OF THE work AND CERTIFY THAT THE ABOVE CONDITIONS WILL BE OBSERVED AT ALL TIMES RECEIVED BY CONTRACTOR/EMPLOYEE ../../.. work COMPLETED work HANDED BACK Received by Safety Mgr/F&R Date: .. Date:..Time:.. THIS PERMIT IS RENEWED I HAVE PERSONALLY CHECKED THE CONDITIONS LISTED OVERLEAF HAVE NOT CHANGED AND CONSIDER IT SAFE FOR work TO COMMENCE FROM TO DISPLAY OF PERMIT THIS PERMIT SHALL BE CLEARLY DISPLAYED AT THE work SITE WITH CONTRACTOR/EMPLOYEE PERFORMING THE work Pink copy to be given by hand to the Site Manager and the Yellow copy to be kept by the person issuing the PERMIT .

4 Upon completion of work and acceptance the Contractor/Employee shall sign and hand back PERMIT to the Site Manager for close-out. PERMIT ISSUE Permits are to be issued by Site Manager. They may be issued by the Engineer in which case they shall be counter signed by the Site Manager. STANDARD CONDITIONS YES NO 1. EXCAVATIONS: When more than deep the following conditions must apply before entry is permitted I. An ENTRY PERMIT must be obtained II. The sides of the excavations must be suitably shored and graded back 2. WELDING I. Is equipment sited in approved safe area? EQUIPMENT: II. Are welding cables in a good condition? III. Is there an insulating bridge in place where cables cross pipelines?

5 IV. Is the welding circuit cable positioned within 2m of the job(NOTE: Earth routing via installed plant is prohibited) 3. FLAME CUTTING I. Is the equipment in a safe area? EQUIPMENT II. Are oxy/acetylene cylinders secured upright in a special trolley rack? III. Confirm flashback arrester fitted Gas cylinders must NOT be taken inside tanks or confined spaces and when not in use must be turned off at the main cylinder valve 4. HAZARDOUS MATERIAL I. Hot work areas must be kept free of loose flammable and combustible material and empty drums. Confirm appropriate action taken. II. Where asbestos, lead or other critical materials are present in the work area, the appropriate Statutory Regulations and Codes of Practice must be strictly observed.

6 Confirm appropriate action has been taken. 5. COMPRESSORS FOR BREATHING EQUIPMENT: The compressor should be sited upwind of the job in an approved safe area free from flammable and toxic vapours. Confirm wind sock is in place. 6. WETTING DOWN: During hot work , chipping, caulking or grinding and disk cutting of materials, concrete or other materials likely to cause a hazardous build-up of temperature, provision must be made for thoroughly wetting the work being carried out. Is coolant available? 7. DRAINS: All drains within 15m of hot work must be covered with a tarpaulin or heavy gauge plastic and sanded. Confirm drains are sealed. 8. FIRE EXTINGUISHER: At least 2 fire extinguishers suitable for the job must be available at the work site.

7 Confirm extinguishers are available. 9. GAS FREE CERTIFICATION Before hot work can commence the work site must be certified gas free. Confirm certificate has been issued. 10. ENTRY PERMIT An entry PERMIT must be obtained before entry is permitted into a confined space. Confirm Entry PERMIT has been issued.