Contract:
File:
Version:
BROOKFIELD Commercial Operations
Document1
3/December 2012
10.2.OH.I.RC.Permit - Hot and or Dust Work
Section 1 - To be completed before works are undertaken
Site Name
Site Address
Permit #
Contractor
Company
Contact #
Work Location/Description
Date/s Valid




Time In/Out
# of workers
The following conditions / Precautions are to be observed
All floor & wall openings within 11m must be
covered to prevent transmission of sparks
Smoke detectors must be isolated in the work area
and procedures followed.
Barricades, warning signs & spark/flash screens
must be provided and utilised.
All combustible materials located within 11m must
be removed or made safe with non-combustible
curtains, metal guards or flame proof covers.

Work area, trenches, pits, etc. must be clear of
flammable liquids, gases, or vapours
 The contractor must supply fire safety equipment
available for use
 The person carrying out the hot work must be
trained in using the Fire Extinguishers/Hose Reel
and in raising/sounding the Alarm
 The hot work area and any adjoining areas must
be patrolled from the start of work and a further
minimum 30 minutes after the work has
completed
Check the box when the item has been completed.
Permit shall not be issued until the following precautions have been checked.
Means other than Hot Work or moving to a safer
location have been considered.
Hot work equipment in good repair.
All walls, ceilings, or floors being worked on are of
non combustible construction (including internally).
All floor and wall openings within 11 metres of the
operation have been tightly covered.
Sprinklers, where provided, are operational and
will not be taken out of service while this work is being
done.
Ample portable extinguishing equipment such as
hose lines or extinguishers have been provided.
Located: ___________________________________
All combustibles have been relocated 11 metres
(further for elevated work) from the operation including
areas on opposite sides of walls if heat can be
transferred to them through the work piece, any which
cannot be moved are protected with metal guards or
fire retardant tarpaulins.
A fire watch has been assigned to watch for fires
or the potential for fires in the work area, on floors
above and below, and on the opposite side of walls.
This watch shall continue during any lunch or rest
period and for at least one hour after the work has
been completed.
The work will be confined to the area or equipment
specified on this permit.
Surrounding floors have been swept clean, and if
combustible, wet down where possible.
No combustible fibers, dusts, vapors, gases, or
liquids in the area. Tanks and equipment previously
containing such have been purged. Where normally
present, the absence of gases or vapors has been
verified by a combustible gas detection instrument. If
there is a possibility of a leak developing in nearby
piping, equipment, or tanks, area is continuously
monitored.
The proposed works do not have the potential to
become a nuisance to the property and the area has
been inspected for the presence of any building air
intake systems. In the event that the works can
become a nuisance and/or there are building air
intake systems present, a property impact
minimisation plan has been agreed with the facility
manager.
Brookfield Commercial Operations, 2012. R. McKee Total pages 2
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Contract:
File:
Version:
BROOKFIELD Commercial Operations
Document1
3/December 2012
If it is necessary to isolate the fire detection system, the form 10.2.OH.I.RC.Permit - Fire Impairment is
to be completed
Fire Watcher
Name
Company
Contact
Approvals
I certify that the worksite and adjacent areas have been inspected by me and declared safe for hot works to
proceed. I understand that the area shall be monitored for 60 minutes after completion of the job and
thoroughly inspected at the end of 60 minutes. I have arranged for the fire panel to be isolated, where
applicable, and all other necessary precautions taken. After the 60 minute period, additional intermittent patrols
should be made for an additional three hours (four hours total after hot work ceases).
Name of competent person
Signature
Date
Precautions listed above have been reviewed, ticked and taken, the work area has been examined and the
permit is authorised for this Hot Work.
Permit issued and reviewed by
(Brookfield Staff)
Date / Time
Senior Staff Member
(Brookfield Staff)
Date / Time
Section 2 - To be completed after works and fire watch are complete
This section to be completed and the permit returned on the completion of the works conducted
Work was completed
Time/Date
Work site checked
Time/Date
FINAL CHECK: I certify that the area has been patrolled for a minimum 30 minutes at the completion fo the
work and no fire conditions were noted. The site is now safe and able to resume normal operation
Work area and all adjacent areas to which sparks and heat may have spread including floors above and below
and on opposite sides of the walls were inspected after the final patrol (four hours after the hot work ceases) is
made.
Authorised and Competent Person
(Competent Person)
Date / Time
Important Information:
 All requests require authorisation from Brookfield Commercial Operations prior to works being carried out
 Fire zones shall not be left isolated overnight
 For Fire Zone Isolations – Form 10.2.OH.I.RC.Permit - Fire Impairment must be completed in addition to this
form
Brookfield Commercial Operations, 2012. R. McKee Total pages 2
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