You are on page 1of 3



Document the hazards and analyse the risks associated with the hot work activities to be undertaken.

P.T.W. Number:

Location of hot wo k! BAC Area / Location: Special access restrictions (due to the task
involving a specific welding type or the location being a hazardous area confined space etc!:

Reason fo hot wo k! "ork activity description: Likely ignition source type(s!:

Flame (welding, soldering, brazing, etc) ot !b"ect (metal surface, plate, etc)

Spark or slag (grinding, cutting, friction tools, welding, etc) !ther#

Add an additional page if the space below is insufficient# Attach #oc'mentation & ( ocee# to Section ) on the fo%%owin* (a*e+ ,om(%ete the Risk Assessment -e%ow+

Ha"a # i#entification$ isk ana%&sis an# cont o% meas' e se%ection! S(ecific Hot Wo k Iss'es!
(tick appropriate)

$he hot work is to be solely undertaken by a contracted party !% &'( personnel and a detailed work method statement ) risk assessment has been previously prepared, reviewed by &'( * is attached to this Form. $he hot work is to be solely undertaken by &'( personnel as per the specific hot work issues detailed below. Step 2 Consider Likelihood What is the likelihood (below) of the hazard consequence in Step 1 occurring. (lmost Cert in LikelPossible .nlikel- / ! re %s e$pected to occur in most circumstances Will probabl( occur at least once *+ent might occur at some time *+ent not e$pected to occur or onl( in e$ceptional circumstances

Risk Assessment Guide

Step 1 Consider Consequences What are the consequences of this hazard occurring? Consider what is the most probable consequence (below) with respect to this work hazard. )*treme Critic l & ,or &inor +nsi$ni0ic nt &ultiple fatalities or permanent in'uries Single fatalit( or permanent in'ur( &edical treatment or lost time in'ur( ,irst aid treatment %ncident or near miss - no treatment Step 3 C lcul te !isk 1. ake Step 1 rating and select the correct column. !. ake Step ! rating and select the correct line. ". #se the risk score where the two ratings cross on the matri$ below. " # "i$h% S # Serious% & # &edium% L # Lo' Consequences +ns &in & , Crit )*t (lmost Cert in & S " " " Likel& & S " " Possible L & & S S .nlikel- / ! re L L & & S

Ha"a #
(+ist the hazards relating to the work)

,ont o%s
(+ist the controls to manage each of the hazards)

)ikelihoo d

Res(onsi-%e Pa t&
(+ist the role, contractor, competency *)or prescribed occupation responsible for implementing the controls)

Risk Assessment
(,ith controls in place# igh, Serious, -edium or +ow)

Risk Assessment Pe sonne%!

%isk 'ssessment (ompleted by#

.ame# .ame# .ame#

/mployer# /mployer# /mployer#

Date# Date# Date#

.e sion 1 Pa*e 1 of /

's per the method of hot work and location described in Section $, identify control re0uirements in the relevant parts below.

P.T.W. Number:

0ene a% Hot Wo k 1 I*nition ,ont o%s 1dentify those 2es NA ,ont o% general hot Fire e2tinguishers supplied by the workgroup ) contractor are to be located immediately ad"acent to the hot work area and within 34m (building ) fi2ed location fire e2tinguishers are not to be relied upon) work and ignition (atch mats or boards are to be positioned over grid5mesh, flooring, grates to catch sparks or slag controls (ombustible and flammable materials or fuel sources are re0uired to be cleared from the area (consider a 36m area around the hot work where practicable and include surfaces below * above the work area) re0uired to be Drains, cable racks, electrical cables and other heat)fire sensitive items are to be covered (consider a 36m area and use fireproof blankets, catch boards and approved covers as applicable) undertaken ' water hose is to be run to the "ob location and primed ready for use as part of the (where appropriate for work locations outdoors and in areas clear of electrical e0uipment) hot work# ' Fire ,atcher is re0uired to watch the area during and)or post work to monitor fire risk, sparks, slag,
(identify as yes or not applicable)

hot ob"ects (consider for work that is arc welding, o2y5cutting or likely to present an ignition hazard post work,
and for work in hazardous areas, in confined spaces, outdoors, in windy conditions)#

During ,ork, and)or 7ost ,ork for a time period of minutes If 2es$ Inc%'#e A##itiona% ,ont o% 3etai%s to -e 4se#! S(ecific Hot Wo k 1 I*nition ,ont o%s 2es NA
$he hot work is to be undertaken on or ad"acent to plant that will re0uire an isolation (such as services, pipes, tanks, pressure vessels)

' fi2ed fire protection or detection system will need to be taken out of service (approval is re0uired for the impairment and the Fire System +og &ook is
to be filled in 8 see also BAC Authorisation below9 approval contacts include# 'irside !perations group# :;4< :4=>9 $erminal 'sset -anager# :;4< :>?=9 $erminals !perations * Facilitation -anager# :;4< :4<;9 /ngineering @roup -anager# :;4< :43=9 Atility Services -anager# :;4< :>6?

$he work area will re0uire specific cleaning, purging, ventilating or pre5 work atmospheric monitoring (due to flammable)e2plosive vapours, dusts,
li0uids or solid residues in the work area ) location)

$he work area will re0uire pre5work cleaning, stripping, surface preparation, or atmospheric monitoring during works (as a result of
surfaces ) coatings that may create harmful emissions when heated or cut)

.' (.ot 'pplicable)

2es NA

$he nature of the work re0uires specific respiratory protection to be worn $he nature of the work re0uires specific controls to be implemented to protect gas leads or other sensitive plant items involved in the work $he hot work involves arc5welding whereby specific controls relating to ensuring electrical safety will be re0uired

A##itiona% Hot Wo k ,ont o%s within ,onfine# S(aces (ontrols#

+ocate e0uipment outside the space where practicable
(such as gas cylinders, hoses, etc unless involved with respiratory devices)

/2traction fan inlet is to be located as close as practicable to the contamination source (ontaminants are to be e2pelled from the space (so that they cannot be recirculated and will not harm other workers) 's arc5welding activities are to be suspended for substantial periods, power sources will need to be de5energised, electrodes removed from holders and holders placed so that accidental contact or arcing cannot occur 's gas welding)cutting activities are to be suspended for substantial periods, torch and cylinder valves are to be closed with the torch and hose connections removed from the space and depressurised

Pe mit Re5'est!
$his acknowledgement signifies a formal re0uest to commence hot works. 's the person re0uesting this permit, 1 hereby certify that# 1 am competent to coordinate this hot work in accordance with the previous %isk 'ssessment * ot ,ork 7ermit details9 1 shall undertake to implement all planned and necessary controls to ensure safe hot work methods9 and 1 shall monitor the hot work hazards and control methods throughout the hot work.





6A, A'tho isation!

$his &'( 'uthorisation signifies that the planning component of the %isk 'ssessment * ot ,ork 7ermit has been completed, inclusive of any impairment notifications (e.g. %escue * Fire Fighting Services, Duty $erminal -gr, @eneral -gr !perations or (orporate Services 1nsurance !fficer for impairments greater than one shift), and that hot work is authorised to commence in accordance with the 7ermit %e0uest.




.e sion 1 Pa*e ) of /


P.T.W. Number:

Section / Im(%ementation Hot Wo ks A'tho isation ("ork Coordinator in %irect Control!:

$he procedures, control measures and precautions appropriate for the safe e2ecution of hot work have been implemented and the persons re0uired to work have been advised of and understand the re0uirements of the %isk 'ssessment * ot ,ork 7ermit.


$his 'uthorisation is valid until the following occurs, or the date and time shown#

Date# Date#

$ime# $ime#


.e sion 1 Pa*e / of /