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Electrical Hot Work Permit

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: