Hot Works Permit

Permit ID

Before commencing any hot works, including cutting, grinding and welding, all contractors, tenants and ADG staff must complete this Permit and have it approved. The purpose of this Permit is to ensure that all safety aspects of hot works have been considered and actioned including reducing the danger to people and damage to infrastructure and services.

Status

Are you or your business registered with ADG? *

YesNo

Note: registration is necessary before any work on ADG Leased Area is permitted.

*Please register your business with ADG before proceeding. Please click here to register.

Have you read the Working on Airport Requirements? *

YesNo

*Please click here to read the requirements. Once completed, please select "Yes" to proceed.

Part 1 – Application Details

Select Airport *

Assessor *

Applicant Name *Person in Charge of Works

Phone *

Business Name *

Email *Applicant's email address

ADG Point of Contact/ Project Manager Details

ADG Point of Contact Name *

ADG Point of Contact Phone Number *

ADG Project Manager Email *

Other PM Email *

Part 2 – Description of Works

Address of Works *

Start Date of Works *

End Date of Works *

*End date must be after the start date of works.

Hours of Work (From) *

Hours of Work (To) *

Describe the planned works *

Start and End date validation

Part 3 - Documentation

Safe Work Method Statement (SWMS) *

Provided Not Provided

Please upload SWMS *

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This should be project/task specific (e.g.: delete all the information not relevant to the job)

Comments

Permit to Commence Work (PERCOW)

ProvidedNot Provided

Please upload your PERCOW *

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Comments

Existing Services Plan

ProvidedNot Provided

Please upload your Existing Services Plan *

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Comments

LV Electrical Access/Isolation Permit

ProvidedNot Provided

Please upload you LV Electrical Access/Isolation Permit *

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Comments

Other Permits (e.g. Confined Space)

ProvidedNot Provided

Please upload your Other Permits (e.g. Confined Space)

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Comments

Fire Services Impairment Notification

ProvidedNot Provided

Note: 48 hours’ notice required

Pleae upload your Fire Services Impairment Notification form

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Comments

Part 4 - Before Hot Works Checklist

Will you be using an angle grinder? *

YesNo

Before Hot Works Checklist *

NoYes (If Yes, move them)

Any combustible materials within 5m?

NoYes (If Yes, move them)

Any flammable materials within 15m?

NoYes (If Yes, move them)

NoYes

Adequate ventilation?

NoYes

Please provide details about adequate ventilation *

Further Comments

Part 5 – Acknowledgement of Applicant

I confirm that:

I will comply with the ADG special conditions decided by the ADG authorised person.
I agree to repair any damage caused to the site or pay the costs associated with any repair work.
I agree to comply with all work health and safety requirements as outlined in our SWMS.
I will return my copy of this Permit for cancellation by the ADG Authorised Person, once work has been safely completed.

Name of Applicant *

Signature

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Date

Part 6 - ADG Special Conditions

Provide details *

Please upload relevant documents (if any)

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Part 7 – Authorisation to Work

Is the permit approved? *

YesNoPending - More Information Required

Reason for disapproval/ Notes to the applicant *

Pending - detail of information required *this information will be returned to the application with a link to edit and resubmit.

Preliminary site inspection by Permit Approver *

YesNo Not Required

I authorise the works listed above to proceed during the specified dates and times, in accordance with the ADG special conditions noted in Part 6 above: *

Name and Title of ADG Authorised Person *

Phone Number *

Date and Time

Part 8 – Cancellation of Permit from the Applicant

Cancellation Date and Time *

As-built drawings or amendments are: *

Not requiredRequired

As-built drawings or amendments will be provided by *Responsible Person

Provided by Date *

Please attach a photo of the site *

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I confirm that: *

The works described in this Permit have been satisfactorily completed, or stopped and made safe.

The fire watch, as described above, has been completed and the Fire System has been restored to full activation. *

The area has been left clean and tidy. *

Any outstanding matters have been forwarded on for action. *

This Permit is now cancelled. *

Name of Person in Charge of Works *

Signature of Person in Charge of Works

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Date - Person in Charge of Works

Part 9 - Cancellation of Permit from ADG

Name of ADG Authorised Person *

Signature of ADG Authorised Person

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Signature Date - ADG Authorised Person

CAPTCHA *

*Please fix the date above.

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