36C26118R0214-081.pdf

HOT WORK PERMIT FOR CONTRACTORS

FOR CUTTING, WELDING, OR OTHER HOT WORK

Date of Issue: Time Issued:

VA Project Title/Number:

Contractor:

Building/Location of Work:

Description of Work:

1. Are sprinklers in service where installed? YES NO

2. Are cutting, welding, and other open flame torches in good repair? YES NO

3. Is work area thoroughly ventilated? YES NO

4. Within 35 feet of actual work:

a. Are floors swept clean of combustible materials? YES NO

b. Are combustible materials/flammable liquids removed? YES NO

c. Are wall and floor openings covered? YES NO

d. Are covers suspended beneath work to collect sparks? YES NO

5. Are sprinkler heads in close proximity protected? YES NO

6. Are non-combustible shields provided near walls, partitions, floors, and roofs? YES NO

7. Do unit and atmospheric conditions permit safe work? YES NO

8. Is fire extinguisher with adequate rating available in the immediate vicinity? YES NO

9. Are personnel trained on fire extinguisher use and sounding a fire alarm? YES NO

10. Is fire watch provided during and 30 minutes after operation? YES NO

12. Have precautions been taken to prevent fire in accordance with NFPA 51B? YES NO

11. List required PPE being used in the work area.

The location of the work has been examined, and permission is granted for this work.

Contractor (sign/date) COR (sign/date) Safety (sign/date)

Date of Issue: Time Issued:

VA Project Title/Number:

Contractor:

Building/Location of Work:

Description of Work:

Fire Watch

Time Hot Work Started Time Hot Work Completed

Work area and all adjacent areas to which sparks and heat might have spread (including floors above and below and on opposite sides of the wall) were inspected 30 minutes after the work was completed and were found fire-safe.

Contractor conducting Fire Watch (sign/date/time at completion of “watch”)

Sentinel Builders, LLC

1D-1, Area above OPP Waiting Room

Sawcutting metal studs