Attachment_17_-_AF_Form_592_Hot_Work_Permit_-_4_Sep_2012.pdf

AF Form 592, 20120904

USAF HOT WORK PERMIT

1. Control Number

2. Date Permit Issued 3. Time Permit Issued 4. Expiration (Date and Time)

5. Company/Organization 6. Company/Organization Phone Number

7. Location

8. Description of Work

9. Is Fire Watch required?

Performed by: Permit Authorizing Individual (PAI)

Fire Watch

10. Before approving any hot work permit, the PAI shall inspect the work area and confirm that precautions have been taken to prevent fire IAW AFI 91-203 and NFPA 51B.

Sprinklers in service

Adequate ventilation

Hot work equipment in good repair

Pressure cylinders are secured properly

Portable fire extinguishers are provided (20 BC rated - immediate area / 80 BC rating back-up wheeled extinguisher)

Explosive atmosphere eliminated (WITHIN 16 M (50 FT) OF WORK)

Flammable liquids, vapors and gases removed

Remove combustibles where possible. Otherwise protect with fire-resistant tarpaulins or metal shields

Floors swept clean of combustibles

Appropriate shields are used

Wall and floor openings are covered

Combustible floors wet down, covered with damp sand, or fire-resistant shields

Any special precautions needed

11. The location where the work is to be performed has been examined, necessary precautions taken and permission is granted for stated work.

Name:

Signed:

Permit Authorizing Individual (PAI)

12. I am fully qualified to perform this operation, understand my responsibilities and my equipment meets all requirements as outlined in AFI 91-203 and NFPA 51B.

Name:

Signed:

Operator or On-scene supervisor

13. Has this process been evaluated by installation Bioenvironmental Engineering? If “Yes,” attach documentation (BE Survey Report, PPE List, etc.). If “No,” obtain BE coordination below.

Name:

Signed/Date:

14. FINAL CHECK: Work area and all adjacent areas to which sparks and heat might spread, including floors above and below and opposite side of walls, were inspected at least 30 minutes or later after the work was completed and were found fire safe.

Name:

Signed:

Facility Number

Aircraft Tail Number

Other:

Floor Number

Inside Hanger Outside Hanger

Yes No

Operator/Supervisor

Contact Number:

Duty Title: