NEW - HOT WORK PERMIT - Fillable.pdf
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- Attached to
- Z1DA--631-23-016 Abate Asbestos Renovation 2024
- Solicitation number
- 36C24124B0054
About this file
This document is a fillable Hot Work Permit form for safety precautions related to open flame or heat-producing work, such as welding, cutting, or soldering. The permit requires the identification of the job-specific information, a checklist of required precautions within 35 feet of the work area, and additional requirements for hot work on walls, ceilings, roofs, or enclosed equipment. It also specifies the need for a fire watch during and for at least 30 minutes after the hot work, as well as extended monitoring if required by the Permit Authorizing Individual (PAI). The form must be signed by the hot work technician, supervisor, and the Contracting Officer's Representative (COR) upon final inspection.
The related federal contract opportunity is for asbestos abatement and renovation work, Solicitation Number 36C24124B0054, issued by the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 1. The contract has a projected start date in 2024, but no other details about the requirement, timeline, or set-asides are provided in the information given.
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Text version
Occupational Safety Final Inspection:
Hot Work Permit BEFORE INITIATING HOT WORK, ENSURE PRECAUTIONS ARE IN PLACE AS REQUIRED BY NFPA 51B AND ANSI Z49.1.
THIS HOT WORK PERMIT IS REQUIRED FOR ANY OPERATIONS INVOLVING OPEN FLAME OR PRODUCING HEAT AND/OR SPARKS. THIS WORK INCLUDES, BUT IS NOT LIMTIED TO, WELDING, BRAZING, CUTTING, GRINDING, SOLDERING, THAWING PIPE, TORCH-APPLIED
ROOFING, OR CHEMICAL WELDING.
Job Specific Information Required Precautions Checklist
Floors swept clean and trash removed?
Explosive atmosphere in area eliminated?
Combustible floors wet down or covered with damp sand or fire-resistive/ non-combustible material or equivalent?
Hot work equipment inspected and in good repair?
Hot Work Technician: (VA/Contractor Name)
Supervisor's Name:
Start Date and Time:
Location of Work:
Scope of Work:
Available sprinklers, hose stream and extinguishers are in service/operable?
Requirements within 35 ft. of Work
Flammable Liquid, dust, lint, and oily deposits removed?
Other combustible storage material removed or covered with listed or approved materials (welding pads, blankets, or curtains, fire-resistive tarpaulins), metal shields, or noncombustible materials?
Ducts and conveyors that might carry sparks to distant combustible material covered, protected, or shut down?
All wall and floor openings covered?
Personnel protected from electrical shock when floors are wet?
Requirements for Hot Work on Walls, Ceilings, or Roofs Construction is noncombustible and without combustible coverings or insulation?
Combustible material on other side of the wals, ceilings, or roof is moved away?
Requirements for Hot Work on Enclosed Equipment
Containers are purged of flammable liquid/vapor?
Enclosed equipment is cleaned of all combustibles?
Pressurized vessels, piping, and equipment removed from service, isolated, and vented?
Extended time amt?
Fire Watch team is trained in the use of equipment?
PAI - Permit Authorizing Individuals
Fire Watch can be required in adjoining areas, above and below?
Comments:
Completion Date and Time:
Per the PAI/Fire Watch, monitoring of Hot Work area has been extended beyond the minimum 30 minute requirement?
Fire Watch is provided during and for a minimum of 30 minutes after Hot Work?
Fire Watch is provided with suitable extinguishers and, where practical, a charged small hose?
Requirements for Hot Work Fire Watch and Monitoring
Sign and Date:
COR Final Inspection
Sign and Date:
Sheet1
| Required Precautions ChecklistHot Work Technician VAContractor Name: |
| Required Precautions ChecklistHot Work Technician VAContractor Name_2: |
| Requirements within 35 ft of WorkSupervisors Name: |
| Requirements within 35 ft of WorkLocation of Work: |
| Requirements within 35 ft of WorkLocation of Work_2: |
| Requirements within 35 ft of WorkLocation of Work_3: |
| Requirements within 35 ft of WorkLocation of Work_4: |
| Requirements within 35 ft of WorkScope of Work: |
| Requirements for Hot Work Fire Watch and MonitoringCompletion Date and Time: |
| Requirements for Hot Work Fire Watch and MonitoringComments: |
| Requirements for Hot Work Fire Watch and MonitoringComments_2: |
| Requirements for Hot Work Fire Watch and MonitoringComments_3: |
| Extended time amtPer the PAIFire Watch monitoring of Hot Work area has been extended beyond the minimum 30 minute requirement: |
| Sign and Date: |
| Sign and Date_2: |
| Hot Work Tech: |
| Supervisor Name: |
| Location of work: |
| Scope of work: |
| Start Date/Time: |
| Complete Date/Time: |
| Comments: |
| Requirements within 35 ft of WorkScope of Work_2: |
| Scope of Work: |
| Scope of Work_2: |
| Requirements for Hot Work on Enclosed EquipmentStart Date and Time: |
| Requirements for Hot Work on Enclosed EquipmentStart Date and Time_2: |
| Requirements for Hot Work on Enclosed EquipmentRow3: |
| Requirements within 35 ft of WorkRow6: |
| Requirements for Hot Work Fire Watch and MonitoringComments_4: |
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