S06 - Amendment 0008 - ATT 11 - Burn Permit.pdf

This is a Burn Permit form issued by the U.S. Department of Veterans Affairs Medical Center in Huntington, West Virginia for cutting and welding operations using portable gas or arc equipment.

The permit is divided into two sections: the upper section to be completed by VA officials and the lower section to be completed by the individual performing burning operations. The VA official section requires documentation of the requesting party, contractor name, project identification, work location (building number, floor, room), issuance and expiration dates, and signature. Special precautions must be addressed, including verification that the person is qualified to perform the work, necessary precautions are taken, fire prevention compliance with NFPA 51B standards, fire alarm system deactivation status, and area venting requirements. The work section requires checklist verification of ten safety items prior to beginning work: fire alarm system deactivation, sprinkler system operation, equipment condition, fire watch placement, spark collection covers, smoke detector deactivation, floor debris clearing, wall and floor protection, fire extinguisher presence, and flammable material relocation. The form mandates recording of work start and completion times, a final inspection thirty minutes after completion to verify the work area is fire-safe, and confirmation that a fire extinguisher was returned to its original location. Workers must post on-site during operations and remain present for qualified VA personnel verification. After normal working hours, the Boiler Plant must be contacted to restore the Fire Alarm System to normal operation. The completed permit must be returned to the VA official upon completion.