[Hotwork] New Hot Work Permit Request - Construction

[Gavin Ketcheside]

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HOT WORK PERMIT REQUEST
CONSTRUCTION AND LARGE RENOVATION PROJECTS
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UCR PROJECT MANAGER: Dexter Galang
PHONE: 9512888685
EMAIL: Dexter.galang at ucr.edu<mailto:Dexter.galang at ucr.edu>

PERMIT REQUESTED BY: Fausto Becerra
DEPARTMENT/CONTRACTOR COMPANY: Mzn construction
PHONE NUMBER: 5624585089
EMAIL: Fbecerra at mzncorp.com<mailto:Fbecerra at mzncorp.com>
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JOB DETAILS

JOB START DATE: 10/26/2024
JOB END DATE: 10/27/2024

LOCATION - BUILDING/FLOOR/ROOM: Roof

THE FOLLOWING PRECAUTIONS HAVE BEEN ACKNOWLEDGED AND WILL BE IN PLACE WHENEVER POSSIBLE (FOR EXCEPTIONS - SEE COMMENTS BELOW)

General:
Available sprinklers, hose streams, and fire extinguishers are in service and operable
, Hot work equipment is in good repair
, Fire detection equipment protected from false activation
, PPE is used to protect workers from physical and chemical hazards while hot work is being performed

 Within 35 feet (11 meters) of work:
Flammable liquids, dust, lint, and oily deposits are removed/cleaned
, Explosive atmosphere in area is eliminated
, Floors are swept and clean
, Combustible floors are wet down and/or covered with fire protection blankets
, Other combustibles are removed when possible or else covered with fire protection blankets or metal shields
, All wall and floor openings are covered
, Fire protection blankets are suspended beneath work
, Ducts and conveyors that might carry sparks to distant combustible materials are protected or shut down

Fire Watch/Hot Work area monitoring:
Fire watch will be provided during and for at least 30 minutes after work stops
  (including lunch and break times)
, Fire watch is supplied with suitable fire extinguishers and fire fighting equipment
, Fire watch is trained in the use of fire extinguishing equipment and in sounding emergency alarm
, Additional fire watch may be required in adjoining areas, above, and/or below
, Fire watch will verify isolated fire detection equipment is returned to normal operation

Work on walls, ceilings and/or roofs:
Construction is non-combustible and without combustible covering or insulation
, Combustibles on both sides of walls, ceilings, and roofs are moved away


Work on enclosed equipment:
Does not apply

OTHER PRECAUTION(S) TAKEN (IF APPLICABLE):
 Water hose present

COMMENTS (WHY PRECAUTION(S) CANNOT BE PUT INTO PLACE):


 End of Request
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FIRE SAFETY APPROVAL
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FIRE SAFETY APPROVAL: DCFM/ Gavin Ketcheside

PERMIT START (DATE): 10/26/24

PERMIT EXPIRES (DATE): 10/27/24

APPROVAL SENT TO REQUESTOR (DATE): 10/25/24

COMMENTS:  Send Work Completion Notice to hotwork at lists.ucr.edu<mailto:hotwork at lists.ucr.edu>

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 Send Work Completion Notice to hotwork at lists.ucr.edu<mailto:hotwork at lists.ucr.edu>
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Select reply and complete the below information before sending.

JOB COMPLETED ON (Please specify DATE and TIME):

SUBMITTED BACK TO EH&S (DATE):

SUBMITTED BY:



________________________________

Recipient Data:
Time Finished: 2024-10-25 13:47:39 MDT
IP: 172.58.211.184
ResponseID: R_5o6ftgsPBiiFNHb
Link to View Results: Click Here<https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/be-a8jboC5eF6IRn1lBDzWhMEUfpccRT%2ETpGVnLyGr52pG81z0mJKfLOy3p0unD%2E1iuHq30jvJjzrWHnWOs9nUbaB5nIKCLZZUlb%2EUG843BLbFPOAwtnsJByJ3d3Q4li5RAut0GJ-2yJ8%2E09bu15NAZVMLCdD%2Ev%2Eali9gUUvm0Li-HSCbOuXIEx7iSd3qEGaAQfZf5Aoe-rf78NkHcYuPu8M6KtE0I8wHWru%2EYu-Y3xwrdPxGvzN%2EtAelvYOqm0AvikZhVLNeNLJdtCAXP4QBsQGDQHtmD0NjG7LRYp2YiEMldpLxzUbpLMpjIVqB8sYGQv%2EtBWs-t3xi1CsaRBvZg>
URL to View Results: https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/be-a8jboC5eF6IRn1lBDzWhMEUfpccRT%2ETpGVnLyGr52pG81z0mJKfLOy3p0unD%2E1iuHq30jvJjzrWHnWOs9nUbaB5nIKCLZZUlb%2EUG843BLbFPOAwtnsJByJ3d3Q4li5RAut0GJ-2yJ8%2E09bu15NAZVMLCdD%2Ev%2Eali9gUUvm0Li-HSCbOuXIEx7iSd3qEGaAQfZf5Aoe-rf78NkHcYuPu8M6KtE0I8wHWru%2EYu-Y3xwrdPxGvzN%2EtAelvYOqm0AvikZhVLNeNLJdtCAXP4QBsQGDQHtmD0NjG7LRYp2YiEMldpLxzUbpLMpjIVqB8sYGQv%2EtBWs-t3xi1CsaRBvZg
________________________________

Response Summary:

PLEASE SELECT PERMIT TYPE:
   Construction and large renovation Projects (PD&C managed)

PRECAUTIONS CHECKLIST: Note: If necessary, please use the comments area below to further explain why a listed precaution cannot be taken in the manner described.
   Available sprinklers, hose streams, and fire extinguishers are in service and operable
   Hot work equipment is in good repair
   Fire detection equipment protected from false activation
   PPE is used to protect workers from physical and chemical hazards while hot work is being performed

WITHIN 35 FEET (11 METERS) OF HOT WORK SITE:
   Flammable liquids, dust, lint, and oily deposits are removed/cleaned
   Explosive atmosphere in area is eliminated
   Floors are swept and clean
   Combustible floors are wet down and/or covered with fire protection blankets
   Other combustibles are removed when possible or else covered with fire protection blankets or metal shields
   All wall and floor openings are covered
   Fire protection blankets are suspended beneath work
   Ducts and conveyors that might carry sparks to distant combustible materials are protected or shut down

FIRE WATCH/HOT WORK AREA MONITORING:
   Fire watch will be provided during and for at least 30 minutes after work stops   (including lunch and break times)
   Fire watch is supplied with suitable fire extinguishers and fire fighting equipment
   Fire watch is trained in the use of fire extinguishing equipment and in sounding emergency alarm
   Additional fire watch may be required in adjoining areas, above, and/or below
   Fire watch will verify isolated fire detection equipment is returned to normal operation

WORK ON WALLS, CEILINGS, AND/OR ROOFS:
   Construction is non-combustible and without combustible covering or insulation
   Combustibles on both sides of walls, ceilings, and roofs are moved away

WORK ON ENCLOSED EQUIPMENT:
   Does not apply

OTHER PRECAUTIONS TAKEN:
   Water hose present

HOT WORK BEING PERFORMED BY:
   Contractor under Planning Design & Construction supervision (large construction projects)

JOB TIME FRAME:
   Start date   10/26/2024
   Start Time   7 AM
   End Date   10/27/2024
   End time   1:41 PM

LOCATION OF HOT WORK (BUILDING, FLOOR, ROOM, ETC.)
   Roof

Project/WO Number:
   110122

FACILITIES SUPERVISOR OR UCR PROJECT MANAGER SUPERVISING THIS JOB:
   Name   Dexter Galang
   Phone Number   9512888685
   Email   Dexter.galang at ucr.edu<mailto:Dexter.galang at ucr.edu>

HOT WORK PERMIT REQUESTOR:
   Name   Fausto Becerra
   Department/Contractor Company   Mzn construction
   Phone Number   5624585089
   Email Address   Fbecerra at mzncorp.com<mailto:Fbecerra at mzncorp.com>

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