ELECTRICAL HOT WORK PERMIT

ELECTRICAL HOT WORK PERMIT
TO BE REVIEWED BY TEAM LEADER PRIOR TO START OF WORK
VALID FOR TECHNICIAN AND DAY ISSUED ONLY

Date:

Time:

Maximum Voltage Present:

Machine Number and Description:

 

 

Specific Reason Equipment Must Be Energized For Servicing:

 

 

Personal Protective Equipment Worn:
< > Flash Resistant Jacket
< > Insulating Gloves
< > Face Shield
< > Rubber Mats
< > Hard Hats
< > Other (List each additional item individually)


Time Work Completed:

 

Date

Technician's Name: