Acorn Heat Works Checklist

Property Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Engineer Name

Date / Time

Date

Time

Area cleared of combustible materials:

Work area segregated with fire-resistant screens

Floors/surfaces protected (sand or non-combustible sheets)

Fire extinguisher present and checked

commencing Risk least

Heat transfer risks checked (other side of surfaces)

Is there a risk of fire or ignition?

Is a fire watch required?

If YES, Fire Watch Person Name:

I confirm that the area will be monitored for at least 1 hour after completion of works.

If NO, please specify plan of action

I confirm that I have carried out the above checks and that all safety measures are in place before commencing hot works.

Signature – I confirm that I have carried out the above checks and that all safety measures are in place before commencing hot works.

Clear Signature