NOAA Form 57-17-09 - Hot Work Permit.pdf
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- Attached to
- MO FY27 Thomas Jefferson Drydock REFERENCES and ATTACHMENTS Federal contract opportunity
- Solicitation number
- 1305M226Q0100REF
About this file
This is a NOAA Form 57-17-09 Hot Work Permit template issued by the National Oceanic and Atmospheric Administration (NOAA) for use on NOAA ships. The permit authorizes personnel to conduct hot work operations and is valid for a maximum of 12 hours from the time of issuance.
The permit identifies six types of hot work activities that may be authorized: welding, cutting, brazing, grinding, sandblasting, and chipping. It requires designation of the specific location where hot work will be performed and identification of the hot work operator as either a crewmember or contractor. Fire watch personnel must also be designated and identified by the same categories. The form includes comprehensive precautions that must be met before hot work commences, including certification of the operator, verification of appropriate personal protective equipment, confirmation that equipment is operable and in good condition, provision of shielding, oxygen and explosive gas level measurements by a competent person, Marine Chemist certification where required for confined spaces or combustible liquid tanks, adequate ventilation, removal or protection of combustible materials, assignment of trained fire watch personnel with communications capability, and de-energization of electrical equipment with lockout/tagout notification. The permit requires signatures and authorization from the Competent Person, Chief Marine Engineer, Officer of the Deck at commencement of hot work, and the Commanding Officer.
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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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