Hot Work Permit

Part 1: Date and Description of Hot Work:

Date Permit Issued: Location of Hot Work: Building: Floor: Room:

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Additional Information on location:

Name and contact information for person performing the Hot Work: Employee Contractor

Name: Company: Phone:

Name: Company: Phone:

Description of the Hot Work being done:

Part 2: Department/Person Authorizing the Hot Work:

Facilities Management
Name: Phone Number:
Other College Department

The Hot Work area has sprinkler protection? Yes No Deactivated Is the Hot Work area on a roof? Yes No

The Hot Work area has smoke detection? Yes No Deactivated

Additional precautions required:

I verify I have reviewed the Hot Work procedures and requirements with the person(s) performing the Hot Work.

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Signature of person authorizing the Hot Work Date

Part 3: Pre-Hot Work Checklist Is this Hot Work necessary?
Equipment for Hot Work has been inspected and found to be in good repair:
free of damage or defects.
A fully charged multi-class (ABC) portable fire extinguisher is immediately
available. (10 lb min)
All flammable and combustible liquids have been removed from the area (at
least 11 meters (35 feet) from the work area).
All combustible materials (wood, paper, cardboard) have been moved (11
meters away) or otherwise protected with fire retardant tarps or sheet metal.
Any potential for a flammable atmosphere has been eliminated.
Area has been cleaned/swept to remove any other combustible material
(lint, sawdust, dust, oil residues).
Is there a safer way?
Combustible flooring/walls (whenever sparks or slag may fall) have been
covered with a fire retardant tarp.
All wall, floor, duct, and ceiling penetrations, where sparks may travel, have
been located and sealed/covered.
Furniture, computers, equipment, and/or other furnishing have been
protected from damage.
Fire alarm pull box, radio, telephone, or cell phone is immediately available
to summon fire department in case of a fire.
Fire watch duration and duties are understood.
Signature of person performing the safety check:

Part 4: Fire Watch

To be completed by employee or contractor responsible for the work. Return this permit to the person who authorized the Hot Work after the Fire Watch has ended.
Fire watch is required during and for 60 minutes after Hot Work, including any breaks.

The work area and all adjacent areas to which sparks and heat might have spread (such as floors below and above, and areas on other sides of walls) have been
inspected and found to be free of fire following completion of work.

Time Fire Watch ended (this must be at least 1 hour after work was completed):

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Name of Fire Watch Signature Date

Distribution: Post at work-site and copy to authorizing person/department.