NOAA Form 57-17-09 - Hot Work Permit.pdf

U.S. DEPARTMENT OF COMMERCE NOAA Form 57-17-09

(1-17) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

HOT WORK PERMIT

THIS PERMIT IS VALID FOR NO MORE THAN 12 HOURS FROM THE TIME ISSUED

NOAA SHIP Check one

PRECAUTIONS

Met N/A

PERMIT

ISSUED

DATE TIME

Hot work operator is certified to perform the hot work indicated.

PERMIT

EXPIRES

DATE TIME

Hot work operator is equipped with appropriate PPE, including respirator.

TYPE of HOT WORK PERMITTED

WELDING CUTTING

BRAZING GRINDING

SANDBLASTING CHIPPING

Hot work equipment is fully operable and is in good condition.

Hot work shielding is provided to protect others from arc.

LOCATION of PERMITTED HOT WORK Competent Person measured oxygen and explosive gas levels. Certified area safe for hot work.

Marine Chemist issued a “ Safe for Hotwork” certificate, as required for Confined Space.

HOT WORK OPERATOR Sufficient ventilation is provided to remove smoke and vapor from the hot work area.

CREWMEMBER CONTRACTOR

Local smoke and heat detection system is secured in hot work area (if practical).

FIRE WATCH PERSONNEL

Marine Chemist issued a “Safe for Hot Work” certificate for locations within or near combustible liquid tanks.

Gas cylinders, manifolds and electric arc units are located outside of the confined space designated for hot work.

CREWMEMBER CONTRACTOR

Combustible materials are removed from hot work area, draped with fire proof cloths or protected with metal shields.

RESTRICTIONS / COMMENTS In adjacent spaces, flammable liquids are removed and combustible materials are moved away from the bulkheads.

In the hot work area and adjacent spaces, Fire Watch personnel are assigned, as required.

SIGNATURE of COMPETENT PERSON Fire Watch personnel are supplied with operable fire extinguishing equipment, ready for immediate use.

I verify the above location has been examined, fire prevention precautions have been taken, and permission for hot work is authorized.

Fire Watch personnel are trained in the use of fire extinguishing equipment and sounding the fire alarm.

CHIEF MARINE ENGINEER (CERTIFIES AREA SAFE for HOT WORK) Fire Watch is assigned for the full period of hot work, plus 30 minutes, including all hot work break periods.

OOD (at COMMENCEMENT of HOT WORK) Fire Watch personnel have established radio communications with the hot work operator and the OOD.

COMMANDING OFFICER (APPROVES HOT WORK PERMIT) Electrical equipment in the hot work area is de-energized. Lock out / Tag out notification posted, as required.