HOT WORK PERMIT

Apply only area specified below

Permit No: Yas_VR_HWP_
This HOT WORK PERMIT is required for any temporary operation involving open flames or producing heat and/or sparks. This includes but not
limited to Brazing, Cutting, Grinding, welding and torch applied water proofing.
This HOT WORK PERMIT will be cancelled automatically after 24 Hrs from the work starting time stated below.
1. ISSUED TO-(a). Retail Unit and Tenant Information
Project Name: Date:
Unit Number/Location:
Retailer: Contractor:
Retail Delivery Manager: Delivery: email
(b). Workers
Name Designation Name Designation Name Designation





(C) Supervision and Safety precautions carried out by Fire watcher:
Person In charge: Contact No:
Contr. Company:
2. DURATION OF WORK
(a). Time- From:07:00hrs To:19:00hrs
3. DESCRIPTION OF WORK
Welding Gas Cutting Grinding
Brazing Waterproofing Other:
Job Description:

4. SAFETY MEASURES CHECKLIST-(Tick where appropriate)
Charged hose reel required to reach all areas All wall and floor opening covered.
Fire blanket and Valid Fire Extinguishers(DCP&CO2)
available and operable
Gas cylinders are kept in the cylinder cage.
Hot work equipment are in good condition Flash back arrestors are in place at cutting Torch inlets
and gas regulator outlets.
Flammable liquids, dust, oil deposits removed Combustible floors wet down, covered with damp
sand/fire resistant sheets.
Explosive atmosphere in area eliminated Floor swept clean
5. FIRE WATCHER REQUIRED (Tick where appropriate)


6. INSTRUCTIONS FOR HOT WORK
Fire watcher during hot work process.
A. Verify safety measures are in place.
Fire watcher is trained raising fire alarm equipment
and giving warning in case of fire.
B. New permits shall be requested for time extension.
C. Completed and retain copy on site.
Monitoring Hot work area for 4Hrs after Job.
D. No Smoking at all time.
Failure to comply will result in an automatic directive to cease all activities and the contractor being removed from site.
7. ACKNOWLEDGEMENT
I confirm that a safe system of work is in place and a full risk assessment and method statement has been completed for this activity of
conduct and that this has been the subject of a briefing to the persons involved in this task prior to the commencement of the activity. I
have verified that the above location has been inspected during operations and required PRECAUTIONS have been taken.
Tenants Supervisor Responsible
Name:______________________________________Date:___________________Sign:_________________________
8. Authorization- Tenants HEALTH&SAFETY Rep.


Tenants-RETAIL DELIVERY MANAGER
Name:
Date:
Signature:
Name:
Date:
Signature:
DISCLAIMER:
The applicant and his/her service provider are fully responsible for ensuring the operation is carried out safely by competent persons and
workplace is safe for anyone may be affected by the operation. The granting of permit by VINDICO RETAIL shall not be construed as VINDICO
RETAIL being responsible in anyway, for any accident that may arise directly or indirectly from your work activities.

Victoria Secret at Yas Mall.
G-032 & G-034a
18/06/2014
Mr. Kayleigh Pullinger
M/s. Deco Emirates LLC
Abul Hashim Welder
Azharul Islam
Welder
Santosh Singh
Deco Emirates LLC
0529021226
M/s. Al Shaya