VA 01 00 00 General Requirements - Attachment 2 (1).pdf
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- Solicitation number
- 36C24822R0173
About this file
This document contains an attachment template for notification of hot work operations by contractor personnel at Department of Veterans Affairs facilities. The template requires contractors to provide details of planned hot work, including the project number and title, facility name, building name and floors, date and time of work, description of work, any special precautions, name of fire watch person if applicable, and comments. Spaces are provided for notification and approval signatures by the contractor and contracting officer's representative (COR). Safety staff must also sign to acknowledge the notification. The purpose of the template is to document hot work notifications and approvals for contractor personnel performing such operations at VA sites, such as welding, cutting, grinding, and other activities requiring an open flame or producing heat and/or sparks.
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Text version
Attachment 2
Notification of Hot Work Operations by
Contractor Personnel (Burn Permit)
SECTION 01 00 00
GENERAL REQUIREMENTS
ATTACHMENT #2
NOTIFICATION OF HOT WORK OPERATIONS
BY CONTRACTOR PERSONNEL
(BURN PERMIT)
PROJECT No. & TITLE:
NAME OF FACILITY:
BUILDING # & NAME:
FLOORS:
ON DATE: Sn M T W Th F St WORK TIME:
WORK TO BE DONE:
SPECIAL PRECAUTIONS:
NAME OF FIRE WATCH PERSON IF APPLICABLE:
COMMENTS:
Section 01 00 00, General Requirements – Attachment #2
Revised March 2018
NOTIFIED BY:
NOTIFIERS SIGNATURE & DATE:
APPROVED WITH COMMENT DISAPPROVED
TITLE & PHONE No.:
CONTRACTOR:
APPROVED
COR NAME:
COR SIGNATURE & DATE:
SAFETY STAFF MEMBER:
SAFETY SIGNATURE & DATE:
Section 01 00 00, General Requirements – Attachment #2
Revised March 2018
| Project # and Title: |
| Name of Facility: |
| Building # and Name: |
| Floors: |
| Work Time: |
| Check Box23: Off |
| Check Box24: Off |
| Check Box25: Off |
| Check Box26: Off |
| Check Box27: Off |
| Check Box28: Off |
| Check Box29: Off |
| Work To Be Done: |
| Special Precautions: |
| Name of Fire Watch Person: |
| Comments: |
| Notified By: |
| Title and Phone #: |
| Contractor: |
| Group38: Off |
| COTR Name: |
| Safety Name: |
| Contract Information: |
| Reset: |
| Print: |
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