NOAA Form 57-17-09 - Hot Work Permit.pdf
NOAA Form PDF 135 KB Posted
- Solicitation number
- 1305M225R0034
About this file
The document is a NOAA Form 57-17-09 Hot Work Permit, a standardized safety form used to authorize and track high-risk work activities involving heat or potential fire hazards on a NOAA ship. The form provides a comprehensive checklist of precautions and safety requirements for performing hot work, including welding, cutting, brazing, grinding, sandblasting, and chipping. The permit is valid for a maximum of 12 hours and requires detailed verification of safety measures such as proper personal protective equipment, equipment condition, ventilation, fire watch personnel, gas and electrical safety, and certification by multiple ship personnel including the Chief Marine Engineer, Officer of the Deck, and Commanding Officer.
The form includes checkboxes to confirm critical safety protocols like measuring oxygen and explosive gas levels, removing combustible materials, positioning fire extinguishing equipment, establishing radio communications, and ensuring trained fire watch personnel are present during and after hot work activities. The multi-step verification process involves different ship personnel confirming safety conditions before, during, and after the hot work is performed, with specific requirements for confined spaces, adjacent areas, and equipment positioning to minimize potential fire or injury risks.
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Other versions and copies of NOAA Form 57-17
| File | Revision | Posted | Attached to |
|---|---|---|---|
| NOAA Form 57-17-09 - Hot Work Permit.pdf Same revision and size as this file | Revision not stated | MO FY27 Thomas Jefferson Drydock REFERENCES and ATTACHMENTS | |
| NOAA Form 57-17-09 - Hot Work Permit.pdf Same revision and size as this file | Revision not stated | Reference Documents for DORFP 1305M224R0042 – NOAA Ship Thomas Jefferson FY25 Repairs Services | |
| NOAA Form 57-17-09 - Hot Work Permit.pdf Same revision and size as this file | Revision not stated | 1305M223QNMAN0122 - NOAA's Ship Thomas Jefferson Drydock FY 2024 | |
| NOAA Form 57-17-09 - Hot Work Permit.pdf Same revision and size as this file | Revision not stated | Drawings/References for the THOMAS JEFFERSON Dockside Repairs FY23 | |
| NOAA_Form_57-17-09_Hot_Work_Permit.pdf | Revision not stated | XP Piping and Valve Repair |
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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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