J01f Above Ceiling Work Permit.pdf

PDF 663 KB Posted

Attached to
PIMC Pharmacy, ATS & Standpipe Federal contract opportunity
Solicitation number
75H701-25-R-00029
Issued by
Department of Health and Human Services Indian Health Service

About this file

The document is an Above Ceiling Work Permit form used to document and track construction or maintenance work performed in ceiling spaces. The form allows contractors to specify the type of work being performed, which includes options such as inspection, electrical work, medical gases, air conditioning, plumbing systems, fire systems, and other infrastructure-related activities. The permit requires detailed documentation, including contractor information, project time period, and inspection checkpoints before and after work completion.

The form includes two primary sections: an initial work permit section to be completed before work begins, and a post-work inspection section to be completed after the work is finished. Both sections require an inspector's signature and provide spaces to note specific work concerns or inspection findings. Key inspection points include checking fire and smoke barrier penetrations, foreign materials touching fire sprinkler pipes, ceiling tile gaps, and medical gas pipe painting. This document appears to be part of a comprehensive safety and documentation process for maintaining infrastructure integrity during ceiling-related maintenance or construction activities.

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Text version

ABOVE CEILING WORK PERMIT

DATE: CONTRACTOR:

NAME: ADDRESS:

PHONE: CONTACT PERSON:

TYPE OF WORK:

a Inspection o Electrical o Data o Other Cables o Medical Gases a

D a a

Piping a Air Conditioning a Insulation work

Fire Stopping

Lighting Nurse callo Fire systems o Plumbing Systems

Project time period:

FROM: TO:

To be completed by PIMC Inspector

Date:

a Discussed locations of nearby fire and smoke barriers a Discussed foreign materials touching fire sprinkler pipe a Discussed gaps in ceilingtile o Discussed painting of medical gas pipes

Work Concerns:

Inspector signature (prior to work beginning)

J01f - Above Ceiling Work Permit

ABOVE CEILING WORK INSPECTION

Date:

o Inspected work area for fire and smoke barrier penetrations o Inspected work area for foreign materials touching fire sprinkler pipe o Inspected work area for gaps in ceiling tile o Inspected work area for painting of medical gas pipes

Inspection Concerns:

Inspector signature (after work completion)

J01h - Above Ceiling Work Permit

File details come from the government source that posted it. Updated .