Hot Work Permit Permit No. ………… Not for use on Tankers / Pipeline Under Part 4.6.2 of the Navigation Bylaw 2009, permission is hereby given for Gas Cutting/Burning/Welding (electric/gas) to be carried out in the following location/s: …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… on board the vessel ……………………………………. at berth ……………………………………… Subject to the following conditions: 1. All combustible materials within surrounding areas removed or made safe. 2. No flammable liquids, vapours, gases or dusts present. 3. Suitable Fire Extinguishers/hoses provided onsite and fully operational. 4. Operator knows how to use fire equipment. 5. Operator knows how and where to raise fire alarm. 6. An inspection of the surroundings of the work area/s is carried out at least one hour after hot work is completed. 7. Other specified conditions: ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… Gas Free Certificate Yes / No Issued by:…………………………………………………… I / We agree with the above conditions and will ensure that they are complied with for the duration of this permit. Signed: For the Vessel ………………………. Position ……………………… Date………………… For the Contractor…………………… Position ……………………… Date………………… Permit Issued By …………………… Position ……………………… Date………………… This permit is valid From … …………Hrs Date……………….. ‘til………..Hrs Date………………… This Permit Must Be Displayed at Work Area If more than one work area, original to be kept in Ships Office / Wheel house and a duplicate copy to be displayed at each work area. Page 39