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Hot work application form

Please complete the following application form if you wish to carry out hot work (gas cutting, burning, welding - electric or gas) on board your vessel while in port.

Health & Safety is very important to us. Please ensure you adhere to the conditions stated on this form. If you wish to print and fill out the form manually, please download a copy here.

Please note, this form is not for use on tankers/pipeline.
If there is more than one work area, the original form is to be kept in the ship's office/wheelhouse, and a duplicate copy to be displayed at each work area.
A representative from the vessel and any contractors involved should be aware of the content.
Keep us informed of any changes by contacting us using the details provided at the end of this page.

Upon submission of this form, the harbourmaster will be in contact in due course to issue your approved permit. This will include your approval number and permitted work period.

Hot work application form

Contact name

Contact email address

Contact phone number

Once this application is approved, under the provisions of the Buller District Council Navigation Safety Bylaw or any subsequent legislation, permission will be given for gas cutting/burning/welding (electric/gas) to be carried out in the locations below. Please include a description of the work you plan to carry out:

Vessel name:

Berth number:

Subject to the following conditions:

All combustible materials within surrounding areas removed or made safe.

No flammable liquids, vapours, gases or dusts present.

No hot work while any bunkering operations are in progress.

Suitable fire extinguishers/hoses provided onsite and fully operational.

Operator knows how to use fire equipment.

Operator knows how and where to raise fire alarm.

An inspection of the surroundings of the work area/s is carried out at least one hour after hot work is completed.

Any other specified conditions:

ANY HOT WORK IN THE VICINITY OF OR IN FUEL TANKS TO BE NOTIFIED IN WRITING TO THE HARBOURMASTER BEFORE WORK STARTS

Issued by:

I/We agree with the above conditions and will ensure that they are complied with for the duration of this permit.

As the representative for this vessel, I agree with the above conditions and will ensure that they are complied with for the duration of this permit.

As the contractor, I agree to the above conditions and will ensure they are complied with for the duration of this permit.

For further information:

Westport Harbourmaster

PO Box 21
Westport 7866
New Zealand

Telephone 03 788 8086
Mobile Phone 021 959 279
email: harbour.master@bdc.govt.nz

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