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

NOAA Form PDF 135 KB Posted

Attached to
Reference Documents for DORFP 1305M224R0042 – NOAA Ship Thomas Jefferson FY25 Repairs Services
Solicitation number
1305M224R0042
Issued by

About this file

This document is a Hot Work Permit form used by the National Oceanic and Atmospheric Administration (NOAA) for its ships. The permit authorizes and outlines the safety precautions for hot work activities such as welding, cutting, and grinding onboard NOAA vessels. It requires the hot work operator to be certified, have appropriate personal protective equipment, and use properly functioning equipment. The permit must be issued by a competent person and approved by the Chief Marine Engineer, Officer of the Deck, and Commanding Officer. Key safety precautions include ensuring the work area is free of combustible materials, providing proper ventilation and fire watch personnel, and verifying gas levels. The permit is valid for up to 12 hours and must be completed in full before hot work can commence.

The related federal contract opportunity is a Delivery Order Competition under an existing IDIQ contract for NOAA Ship Thomas Jefferson FY25 Repair Services. It is only open to contractors awarded the Region II IDIQ contract. The solicitation number is 1305M224R0042.

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Text version

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.

NOAA SHIP:
DATE:
TIME:
DATE_2:
TIME_2:
WELDING: Off
BRAZING: Off
SANDBLASTING: Off
CUTTING: Off
GRINDING: Off
CHIPPING: Off
CREWMEMBER: Off
CONTRACTOR: Off
CREWMEMBER_2: Off
CONTRACTOR_2: Off
RESTRICTIONS COMMENTS:
HOT WORK OPERATOR:
LOCATION of PERMITTED HOT WORK:
FIRE WATCH PERSONNEL:
VENT: Off
PERMIT: Off
SHIELD: Off
OPERABLE: Off
EQUIPPED: Off
CERTIFIED: Off
DETECTION: Off
SAFE: Off
CYLINDERS: Off
DRAPED: Off
ADJACENT: Off
FW EQUIP: Off
FW TRAIN: Off
FW 30: Off
FW RADIO: Off
LOTO: Off
RESET:
O2 GAS: Off
FW ASSIGN: Off

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