Shipboard Welding and Cutting Permit

Permit No. Date
Vessel Name Location/Area
Work Order/Job No. Duration (From - To)
Description of Work

Personnel Involved

Welder's Name Certificate No.
Supervisor Company/Dept.
Gas Watch/Fire Watch Time On Duty

Pre-Work Safety Precautions

Atmosphere Testing

Tested By Date/Time
Oxygen (%) LEL (%)
Other (Specify)

Final Checks & Approval

Authorized Officer


Signature: ___________________
Date/Time: _________________
Welder


Signature: ___________________
Date/Time: _________________
Supervisor


Signature: ___________________
Date/Time: _________________