S02_Hot Work Permit VACWM Version 5.pdf
PDF 97 KB Posted
- Attached to
- Z2QA--631-22-002 Exterior Stair Improvement
- Solicitation number
- 36C24122B0006
About this file
This document contains a hot work permit template and related federal contract opportunity. The hot work permit template outlines safety precautions and procedures required for any temporary operation involving open flames, heat, or sparks such as brazing, cutting, grinding, or welding. Information required on the permit includes the type of hot work to be performed, start and completion dates and times, safety checks, approvals from supervisors and safety personnel, and fire watch requirements after work is complete.
The related federal contract opportunity is solicitation number 36C24122B0006 to provide exterior stair improvements for the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1. The opportunity type is a solicitation, and interested parties should refer to the attached invitation for bid for additional details on products or services required.
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Text version
Comments:
Complete Date and Time:
Location of Work:
HOT WORK PERMIT
THIS PERMIT IS REQUIRED FOR ANY TEMPORARY OPERATION INVOLVING OPEN FLAMES, HEAT, OR
SPARKS; SUCH AS" BRAZING, CUTTING, GRINDING OR WELDING (ANY TORCH USE).
INFORMATION
Safety personnel signing this permit must have valid 30 hour OSHA card and has verified, by his/her signature that all requirements located have been verified and completed.
REQUIRED PRECAUTIONS CHECKLIST
Available sprinklers, hose streams and
COR Final Check Name and Signature: Date:
Complete Date and Time:
Supervisor Name:
Supervisor's Signature:
Hot Work Technician VA Employee/Contractor Name:
Type of Hot Work to be Performed:
Start Date and Time:
Complete Date and Time:
HOT WORK PERMIT
THIS PERMIT IS REQUIRED FOR ANY TEMPORARY OPERATION INVOLVING OPEN FLAMES, HEAT, OR
SPARKS; SUCH AS" BRAZING, CUTTING, GRINDING OR WELDING (ANY TORCH USE).
INFORMATION REQUIRED PRECAUTIONS CHECKLIST
Available sprinklers, hose streams and extinguishers extinguishers are in service/operable? Safety personnel signing this permit must have valid 30 hour OSHA card and has verified, by his/her signature that all requirements located are in service/operable?
Hot work equipment inspected and in good repair?
Requirements within 35 ft. of work
Combustable floors wet down, covered with damp have been verified and completed.
Hot work equipment inspected and in good repair?
Hot Work Technician VA Employee/Contractor Name:
Requirements within 35 ft. of work
Combustable floors wet down, covered with damp sand or fire resistive sheets
Remove other combustables or cover with fire sand or fire resistive sheets
Remove other combustables or cover with fire blankets or curtains blankets or curtains
Wall and floor openings covered
Protect or shut down ducts that may carry sparks to Protect or shut down ducts that may carry sparks to
Location of Work: Wall and floor openings covered Work on walls, ceilings, or roofs combustable areas combustable areas
Type of Hot Work to be Performed: Work on walls, ceilings, or roofs
Construction is non-combustable Construction is non-combustable Combustables have been moved away
Work in enclosed equipment Enclosed permit quipment cleaned of all
Supervisor Name:
Supervisor's Signature:
Combustables have been moved away
Work in enclosed equipment Enclosed permit quipment cleaned of all combustables Containers purged of flammable liquids or vapors Start Date and Time: Containers purged of flammable liquids or vapors combustables Pressurized vessels/piping: isolated or vented Pressurized vessels/piping: isolated or vented Fire watch/monitoring of hot work area Complete Date and Time: Fire watch/monitoring of hot work area Fire watch shall be providedf 30 minutes after work Fire watch shall be providedf 30 minutes after work Fire watch shall be provided with extinguisher(s)
Fire watch is trained in the use of extinguishers and
Complete Date and Time: Fire watch shall be provided with extinguisher(s)
Fire watch is trained in the use of extinguishers and sounding alarm Fire watch may be required in adjoining areas to sounding alarm Complete Date and Time: Fire watch may be required in adjoining areas to Monitor hot work area for three hours after job is work work
Monitor hot work area for three hours after job is Safety Final Check and Approval Name and Signature: Date:
complete complete
Comments:
COR Final Check Name and Signature: Date:
Safety Final Check and Approval Name and Signature: Date:
Sheet1
| REQUIRED PRECAUTIONS CHECKLISTINFORMATION Safety personnel signing this permit must have valid 30 hour OSHA card and has verified by hisher signature that all requirements located have been verified and completed: |
| REQUIRED PRECAUTIONS CHECKLISTINFORMATION Safety personnel signing this permit must have valid 30 hour OSHA card and has verified by hisher signature that all requirements located have been verified and completed_2: |
| Requirements within 35 ft of workHot Work Technician VA EmployeeContractor Name: |
| Requirements within 35 ft of workHot Work Technician VA EmployeeContractor Name_2: |
| Requirements within 35 ft of workLocation of Work: |
| Requirements within 35 ft of workLocation of Work_2: |
| Work on walls ceilings or roofsType of Hot Work to be Performed: |
| Work on walls ceilings or roofsSupervisor Name Supervisors Signature: |
| Work in enclosed equipmentSupervisor Name Supervisors Signature: |
| Work in enclosed equipmentStart Date and Time: |
| Work in enclosed equipmentStart Date and Time_2: |
| Fire watchmonitoring of hot work areaComplete Date and Time: |
| Fire watchmonitoring of hot work areaComplete Date and Time_2: |
| Fire watchmonitoring of hot work areaComplete Date and Time_3: |
| Fire watchmonitoring of hot work areaComplete Date and Time_4: |
| Fire watchmonitoring of hot work areaComplete Date and Time_5: |
| COR Final Check Name and Signature DateRow1: |
| Safety Final Check and Approval Name and Signature DateRow1: |
| REQUIRED PRECAUTIONS CHECKLISTINFORMATION Safety personnel signing this permit must have valid 30 hour OSHA card and has verified by hisher signature that all requirements located have been verified and completed_3: |
| REQUIRED PRECAUTIONS CHECKLISTINFORMATION Safety personnel signing this permit must have valid 30 hour OSHA card and has verified by hisher signature that all requirements located have been verified and completed_4: |
| Requirements within 35 ft of workHot Work Technician VA EmployeeContractor Name_3: |
| Requirements within 35 ft of workHot Work Technician VA EmployeeContractor Name_4: |
| Requirements within 35 ft of workLocation of Work_3: |
| Requirements within 35 ft of workLocation of Work_4: |
| Work on walls ceilings or roofsType of Hot Work to be Performed_2: |
| Work on walls ceilings or roofsSupervisor Name Supervisors Signature_2: |
| Work in enclosed equipmentSupervisor Name Supervisors Signature_2: |
| Work in enclosed equipmentStart Date and Time_3: |
| Work in enclosed equipmentStart Date and Time_4: |
| Fire watchmonitoring of hot work areaComplete Date and Time_6: |
| Fire watchmonitoring of hot work areaComplete Date and Time_7: |
| Fire watchmonitoring of hot work areaComplete Date and Time_8: |
| Fire watchmonitoring of hot work areaComplete Date and Time_9: |
| Fire watchmonitoring of hot work areaComplete Date and Time_10: |
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