Hot Work Permit Application Test FormHome / Hot Work Permit Application Test Form Hot Work Permit Application Hot Work Being Done By:Please choose one of the following:* Employee Contractor Name* Email* Phone* Hot Work Project:Work Order #* Date Submitted* MM slash DD slash YYYY Start Date* MM slash DD slash YYYY Time* : Hour Minute AM PM AM/PM End Date* MM slash DD slash YYYY Campus*Please select a campusArlingtonFairfaxScience & TechnologyAll Other LocationsArlington BuildingHazel HallVan Metre Hall (Formerly Founders Hall)Vernon Smith HallFairfax BuildingsPlease choose buildingADAMS HALLAMHERST HALLAQUATIC CENTERAQUIA BUILDINGARLINGTON ORIGINAL BLDGART AND DESIGN BLDGBRUNSWICK HALLBUCHANAN HOUSEBUCHANAN HOUSE GARAGEBUCHANAN HOUSE STABLECAROW HALLCARROLL HALLCARTY HOUSECENTRAL HEAT/COOL PLANTCENTRAL WAREHOUSECHILD DEVELOPMENT CENTERCOLLEGE HALLCOMMONWEALTH HALLCONCERT HALL-CTR FOR ARTSDAVID KING JR HALLDICKENSON HALLDOMINION HALLEAGLEBANK ARENA (PAT CTR)EISENHOWERENGINEERING BLDGENTERPRISE HALLESSEX HALLEXPLORATORY HALLFACILITIES ADMINISTRATIONFENWICK LIBRARYFIELD HOUSEFINLEYFM ARCHIVES AND SHOPSFRANKLIN HALLGMU SOFTBALL STADIUMGRAYSON HALLHANOVER HALLHARRIS THEATREHARRISON HALLHVII-BLUERIDGE HALLHVII-NORTHERN NECKHVII-PIEDMONT HALLHVII-SANDBRIDGEHVII-SKYLINEHVII-SOUTHSIDE DININGHVII-TIDEWATER HALLHVIIC - EASTERN SHOREHVIIC - HAMPTON ROADSICA MAINTENANCEINNOVATION HALLJACKSON HALLJEFFERSON HALLJOHNSON CENTERKENNEDY HALLKRASNOWKRUG HALLLECTURE HALLLIBERTY SQUARE ALIBERTY SQUARE BLIBERTY SQUARE CLIBERTY SQUARE DLIBERTY SQUARE ELINCOLN HALLMADISON HALMAINTENANCEMASON GLOBAL CENTERMASON HALLMERTEN HALLMONROEMUSIC/THEATER BLDGNOTTOWAY ANNEXPARKING SERVICESPERFORMING ARTSPETERSON FAM HLTHPLANETARY HALLPOLICE & SAFETY HEADQTRSPOTOMAC HEIGHTSPRK DECK I-MASON PONDPRK DECK II-SHENANDOAHPRK DECK III-RAPPAHANNOCKRAC-REC/ATHL COMPLEXRESEARCH HALLROBINSON HALLROGERSROOSEVELTSTUDENT UNION ITAYLORTHE HUBTHOMPSON HALLTRUMANWASHINGTON HALLWESTWEST CAMPUS PAVILIONWHITETOPWILSON HALLSciTech BuildingsPlease choose buildingCHARLES COLGAN HALLDISCOVERYFREEDOM RECREATION CENTERPW PHYSICAL PLANT GARAGEFACILITIES CONST. MODULEPW PHYSICAL PLANT MODULEBULL RUN HALLBIO-MED RESEARCHHYLTON PERFORMING ARTSBRL ANNEXINSTITUTE ADV BIOMED RSCHBEACON HALLAll other locationsPlease choose buildingMason Ferry Garage - PSCPoint of View - POVPoint of View East Cottage - POVPoint of View Waste Treatment Plant - POVPotomac Science Center - PSCSignal Hill - LSMSC Academic Building - SCBISMSC Dining - SCBISMSC Residence Hall - SCBIFloor:* Area:* Nature of the Job:* Does the Fire Alarm need to be turned off?*NoYesWho is doing the Fire Watch?Name* Phone* Authorization:I verify the above location has been examined, the precautions check on the Required Precautions Checklist have been taken to prevent, fire, and permission is authorized for work. Name* Phone* Required Precautions Checklist (if needed) Automatic Fire Detection has been disabled Available sprinklers, hose streams, and extinguishers are in service / operable Hot work equipment is in good repair Requirements within 10 m (35 ft) of work: Flammable liquids, dust, lint, and oil deposits have been removed. Explosive atmosphere in area has been eliminated. Floors have been swept clean. Combustible floors have been wet down, covered with damp sand or fire-resistant sheets. Other combustibles have been removed where possible. Otherwise, protect with fire-resistant tarpaulins or metal sheets are in place. All wall and floor openings are covered. Fire-resistant tarpaulins are suspended beneath work. Work on walls or ceiling/enclosed equipment: Construction is non-combustible and without combustible covering or insulation. Combustibles on other side of walls have been removed. Ensure no danger exists by condition of heat into another area. Enclosed equipment has been cleaned of all combustibles. Containers have been purged of flammable liquids/vapors. Hot work area monitoring: A monitor will be provided during and for 30 minutes after work: Name:* Phone:* A monitor is supplied with suitable extinguishers. A monitor is trained in use of this equipment and in sounding alarm. A monitor may be required for adjoining areas, above and below. Monitor hot work area 30 minutes after job is completed. Fire alarm or suppression system impairment: Fire watch posted in building. Other precautions takenConfined Space entry permit required?* Yes No Area protected with smoke/heat detection?* Yes No Ample ventilation to remove smoke/vapor from work area?* Yes No Lockout/tag-out required?* Yes No
