VA 01 00 00 General Requirements - Attachment 2.pdf
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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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