Fillable HotWorkPermitRequest AhotworkpermitisrequiredforoperationonanyFPUpropertyinvolvingopenflameorproducingheatand/or sparks.AllprecautionsasrequiredbyUniversityPoliciesandProcedures,theFloridaFirePreventi

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HotWorkPermitRequest AhotworkpermitisrequiredforoperationonanyFPUpropertyinvolvingopenflameorproducingheatand/or sparks.AllprecautionsasrequiredbyUniversityPoliciesandProcedures,theFloridaFirePreventionCode,NFPA 51B,OSHA1910.252,andANSIZ49.1mustbemetortheHotWorkisnotpermitted. Section1:HotWorkOperator(HWO) 1. VerifyFPUHWOsasstaff,students,and/oremployeeshavecompletedHotWorkSafetyTraining. Contractorsarerequiredtohaveanestablishedhotworkprogramwithapprovedoperatorsanddesignated (Florida Polytechnic University)

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The HotWorkPermitRequest AhotworkpermitisrequiredforoperationonanyFPUpropertyinvolvingopenflameorproducingheatand/or sparks.AllprecautionsasrequiredbyUniversityPoliciesandProcedures,theFloridaFirePreventi form is 2 pages long and contains:

  • 2 signatures
  • 59 check-boxes
  • 26 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Florida Polytechnic University

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HotWorkPermitRequest
HotWorkPer
mitRequest
1
AhotworkpermitisrequiredforoperationonanyFPUpropertyinvolvingopenflameorproducingheatand/or
sparks.AllprecautionsasrequiredbyUniversityPoliciesandProcedures,theFloridaFirePreventionCode,NFPA
51B,OSHA1910.252,andANSIZ49.1mustbemetortheHotWorkisnotpermitted.
Section1:HotWorkOperator(HWO)
Instructions:
1. VerifyFPUHWO’sasstaff,students,and/oremployeeshavecompletedHotWorkSafetyTraining.
Contractorsarerequiredtohaveanestablishedhotworkprogramwithapprovedoperatorsanddesignated
PAI.Ingeneral,thePAImaynotbethesamepersonaseithertheHotWorkOperatorortheFireWatch.
2. FillinSection1completely.Incompleteformswillnotbeapproved.
3. PrintformandturnintoyourPermitAuthorizingIndividual(PAI)orFacilitiesandSafetyServices(FS&S)at
leastfive(5)workdayspriortorequestedworkstartdateforcompletionofSection2onsiteattimeofwork
start.
4. Obtainapprovalsignatures,verifysite,executeworkasdescribedandinaccordancewithanyconditions
notedonpage2,andremainonsiteforfirewatchfor30minutesafterworkhasbeencompleted.
HotWorkDoneby:
Contractor‐CompletedcompanyHotWorkPermitsignedbycompanydesignatedPAIrequired.
FacilitiesandSafetyServices Employee
Other:__________________________________
HWOName(FPUorContractor)
HWOPhoneNumber
HWOFPUDepartmentorContractorName
FPUSupervisororProjectManagerName
FPUSupervisororPMPhoneNumber
ContractorPhoneNumber
ConstructionSite
OngoingDesignatedArea EmergencyRepair
WorkLocationType:
IncidentalWorkOccupiedBuilding
LocationDescription(bespecific):
CampusName
SiteLocation
BuildingName
BuildingNumber
FloorandRoomorAreaDesignation
WorkSchedule:Initialrequestnottoexceed14daysbutmaybeextendedwithadditionalsitereview.
Date(s) Times
Duration(Days)
ExtendedDaysRequested ExtendedSiteVisitDate
Approved Disapproved By
DescriptionofWorkandEquipmentUsed(TypeandManufacturer):
HWOSigned: Date
Section2:PAIorF&SSReview
FacilitiesandSafetyServices
Phone:(863)874‐8722Fax:(863)874‐8715
Email:safetyservices@floridapoly.edu
click to sign
signature
click to edit
HotWorkPermitRequest
HotWorkPermitRequest
FacilitiesandSafetyServices
Phone:(863)874‐8722Fax:(863)874‐8715
Email:safetyservices@floridapoly.edu
2
PAIName
PAIContactPhoneNumber
PAIFPUDepartmentName
PAIChecklist.PAItoverifytheitemsbelowpriortoworkstart.
Yes
No
HWOhasappropriatesafetytraining(confinedspace,laddersafety,PPE,firesafety,hotwork,etc.).
Hotworkequipmentisingoodworkingconditioninaccordancewiththemanufacturer’sspecifications.
Flashbackarrestorsproperlyinstalled.
Electricalcomponentsingoodcondition.
PPE&areaprotectiveequipmentprovided,approvedtoANSIstandards,andingooduseablecondition.
Shieldsinplaceforanyareavisiblebyotherswherebrightlightwouldbeirritatingtovision.
Facilitiescoordinationinplaceforalarmandsuppressionsystemfirewatching(nothotworkwatch).
Availablesprinklers,hosestreams,andextinguishersareinservice/operable.
Confinedspaceentrypermitobtainedwhererequiredandlockouttagoutproceduresfollowed.
Ampleventilationisprovidedtoremovesmokefumesandvaporsfromworkarea.
Personnelandequipmentproperlysupportedforelevatedhotwork.
Fire‐resistantblanketsuspendedbeneathelevatedwork.
Firewatchsuppliedwithsuitableextinguishersandtrainedinuseofequipmentandinsoundingalarm.
Fuelorgasfilledequipmentisshutdownandpurgedpriortowork.
Flammableliquids,dust,lintandoildepositsremovedfromareaorprotected.
Hazardousorexplosiveatmospheresinareaeliminatedandverifiedwithmonitor/detector.
Floorssweptcleanofcombustiblesandanytrashremoved.
Areaconstructionnoncombustible,w/ocombustiblecoveringorinsulation,requiresnospecific
protectivemeasures.
Combustiblefloors&areacomponentsdampenedorcoveredw/fire‐resistantmaterialssheetsordamp
sand.
PPEprovidedfromelectricalshocksindamplocations.
Removeallcombustibleswherepossible.Protectunmovableitemswithlistedorapprovedfire‐resistant
blanketscreens,curtainsormetalshields.
Verifynocombustiblesonothersidesofadjacentwalls&insideenclosedequipment.Protectasneeded.
Allwallandflooropeningscovered.Ductsandventsthatmightcarrysparkstodistantcombustible
materialscovered,protected,orshutdown.
Nodangerexistsbyconductionofheatintoanotherroomorareathroughpipes,walls,orstructural
members.
HWOinstructedtoandacknowledgestomaintaincontinuoushotworkfirewatchforthedurationofthe
workandfor30minutesafterworkiscompleted.
EquipmentReviewed(TypeandManufacturer):
Anychangestothereviewedequipmentorsiteconditionsmustbere‐inspectedandorre‐permitted.
Conditions&Comments:
Periodicsitevisitsmaybeexecuted.Unsafeconditionsidentifiedatanytimewillvoidanypriorapprovalsandrequire
permitresubmission.
FINALCHECK‐Workareaandalladjacentareastowhichsparksandheatmighthavespread(includingfloors
aboveandbelowandonoppositesideofwall(s)wereinspected30minutesaftertheworkwascompleteand
werefoundfiresafe.
PAI:Signandcompletethisform.ProvideacopytoHWOandas
eparatecopytoF&SS.
PAISigned: Date
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HotWorkPermitRequest AhotworkpermitisrequiredforoperationonanyFPUpropertyinvolvingopenflameorproducingheatandor sparks.AllprecautionsasrequiredbyUniversityPoliciesandProcedures,theFloridaFirePreventionCode,NFPA 51B,OSHA1910.252,andANSIZ49.1mustbemetorthe

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Completed 15 August 2020

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