A combined hot work permit and energy isolation record for worksites where ignition sources meet flammable process. Two parts — the permit that authorises the work, and the isolation register that proves the energy was actually removed and verified before anyone struck an arc.
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Description of work:
Equipment or system: Work order:
Type: (welding, cutting, grinding, brazing, open flame, spark-producing tool, other)
Performed by: Company:
| Control | Confirmed before work starts | Y / N / N-A | Evidence or gap |
|---|---|---|---|
| Alternative to hot work considered | Cold cutting, mechanical fastening or removal to a designated hot work area was considered and rejected for a recorded reason. | ||
| Area cleared of combustibles | Combustible material removed to a safe distance or protected with fire blankets. | ||
| Openings covered | Drains, ducts, floor openings, cracks and conveyors covered or sealed. | ||
| Flammable process isolated | Adjacent process lines and vessels isolated, drained and purged as required. | ||
| Sewers and drains protected | Vapour path from drains considered and controlled. | ||
| Fire suppression at hand | Correct extinguisher type present and in date; hose or suppression available as required. | ||
| Ventilation adequate | Fume extraction and general ventilation adequate for the process and space. | ||
| Barriers and signage | Area barricaded; screens in place to protect other workers from arc flash and sparks. | ||
| Simultaneous operations reviewed | Other work in the area reviewed for conflict. |
Test immediately before work starts and at the frequency set below. Record every test — a permit without test times is not evidence of anything.
| Time | LEL % | Oxygen % | H₂S / toxic | Tester initials | Result |
|---|---|---|---|---|---|
Detector make / serial: Bump test / calibration date:
Re-test frequency required: Continuous monitoring in place:
| Requirement | What good looks like | Y / N / N-A | Evidence or gap |
|---|---|---|---|
| Fire watch assigned | A named person, not an additional duty for the welder. | ||
| Trained and equipped | Trained in extinguisher use and alarm raising; extinguisher in hand. | ||
| Present throughout | Present for the whole of the work, including breaks. | ||
| Post-work monitoring | Continues for the period required by your site procedure after work ends, then checks again before leaving. | ||
| Means of raising alarm | Radio or alarm point confirmed working before work starts. |
Fire watch name: Post-work watch duration required:
Watch ended at: Final area check by:
Tick every source present. An isolation that misses one source is not an isolation.
| # | Isolation point / device | Energy type | Method (lock, blind, spade, disconnect) | Lock / tag ID | Applied by | Verified by |
|---|---|---|---|---|---|---|
| Requirement | What good looks like | Y / N / N-A | Evidence or gap |
|---|---|---|---|
| Stored energy released | Pressure bled, springs relaxed, capacitors discharged, loads lowered or blocked. | ||
| Drain and vent open | Left open where the procedure requires, to prove and maintain the isolation. | ||
| Zero-energy verified at the work point | Verified by test at the point of work — try-to-start, gauge reading, or instrument test. | ||
| Verification method recorded | How zero energy was proven, not just that someone says it was. | ||
| Personal locks applied | Every worker on the job has applied a personal lock to the group device. |
Zero-energy verification method used:
Verified by: Time:
| Name (print) | Lock ID | Lock applied | Lock removed | Signature |
|---|---|---|---|---|
This template is general guidance, not legal advice, and does not replace a site-specific procedure written by a competent person. Confirm every requirement against the current regulation and your own process hazard analysis before use.