VA 01 00 00 General Requirements - Attachment 2.pdf

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Z2DZ--FY22: NRM Tier 2 (PROJ: 673-CSI-127) DB Replace Cardiac Cath Lab 1
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36C24822R0173
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This document contains an attachment to a general requirements section of a construction contract. The attachment is a notification of hot work operations form to be completed by contractor personnel for any burn permit work. It requires details of the project such as number and title, facility name, building number and name, floors where work will take place, date and time of work. It specifies the work to be done, any special precautions, name of fire watch person if applicable, and space for additional comments. It is to be notified, approved and signed by various parties including the contractor, contracting officer representative, and safety staff member.

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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:

File details come from the government source that posted it. Updated .