[Hotwork] NEW Hot Work Permit Request - Facilities Services and Other Departments
Daniel Mendez
daniel.mendez at ucr.edu
Wed Mar 26 13:21:06 PDT 2025
Job completed on 3/25/2025 at 2:00pm
Submitted back to EH&S on 3/25/2025
Submitted by Daniel Mendez
On Tue, Mar 25, 2025 at 12:49 PM Tracy Stark <tracy.stark at ucr.edu> wrote:
> Approved. Please have a copy (electronic or paper at the job site.)
>
> Please fill out below and reply all to this email to close the permit.
>
>
>
> *------------------------------------------------------------------------------------------------------*
> *Select reply all and complete the below information before sending.*
>
> *JOB COMPLETED ON (Please specify DATE and TIME):*
>
>
>
> *SUBMITTED BACK TO EH&S (DATE):SUBMITTED BY:*
>
> ---------------------------------------------------------------------------------------------------------------------------
>
>
>
> *Tracy Stark*
> Safety Engineer
> UCR Environmental Health & Safety
> tracy.stark at ucr.edu
> (951) 827-5118
> Book time with me on Zoom or in-person here.
> <https://calendar.app.google/ARaUNPsZHLaZngta9>
>
>
> On Tue, Mar 25, 2025 at 12:31 PM Hot Work Program <
> noreply at qemailserver.com> wrote:
>
>> [image: Graphic.php?IM=IM_8HvGTwJPt7awyvX]
>>
>> *HOT WORK PERMIT REQUEST FACILITIES SERVICES AND OTHER DEPARTMENTS*
>>
>> -----------------------------------------------------------------------------------------------------
>> *HOT WORK IS BEING PERFORMED BY: *UC Riverside employee
>>
>> *PERMIT REQUESTOR:* Daniel mendez
>> *DEPARTMENT: *Sheetmetal shop
>> *PHONE NUMBER:* 9516084082
>> *EMAIL: *Dmendez at ucr.edu
>>
>> *PROJECT MANAGER/SUPERVISOR: *Cory Gryniuk
>> *PHONE NUMBER: *9517436159
>> *EMAIL: *Cory.gryniuk at ucr.edu
>>
>> *PERSON PERFORMING HOT WORK: *Daniel mendez
>> *COMPANY/DEPARTMENT: *Sheetmetal shop
>> *PHONE NUMBER: *9516084082
>>
>> *PERSON PERFORMING FIRE WATCH: *Jesse Guzman
>> *COMPANY/DEPARTMENT: *Plumbing shop
>> *PHONE NUMBER: *9516084087
>>
>> -----------------------------------------------------------------------------------------------------------------------------
>> *JOB DETAILS*
>>
>> *JOB START DATE: *03/25/2025 12:30pm
>> *JOB END DATE: *03/25/2025 2:30pm
>>
>> *LOCATION - BUILDING/FLOOR/ROOM*: Steam plant
>>
>> *JOB DESCRIPTION: *
>> Weld cover bracket for shaft in the cooling tower
>>
>>
>> *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:*
>> Does not apply
>>
>> *Work on enclosed equipment:*
>> Does not apply
>>
>> *OTHER PRECAUTION(S) TAKEN (IF APPLICABLE): *
>>
>>
>> *COMMENTS (WHY PRECAUTION(S) CANNOT BE PUT INTO PLACE): *
>>
>>
>>
>>
>>
>> * End of Request
>> -----------------------------------------------------------------------------------------------------------------------------
>> EH&S Approval
>> *
>>
>> *------------------------------------------------------------------------------------------------------*
>>
>> *EH&S APPROVAL: Tracy Stark *[image: T signature.jpg]
>>
>>
>> *PERMIT START (DATE): * 03/25/2025 12:30pm
>>
>> *PERMIT EXPIRES (DATE): 3/26/2025*
>>
>> *APPROVAL SENT TO FS (DATE): 3/25/2025*
>>
>> *COMMENTS:*
>>
>>
>>
>>
>>
>> ------------------------------
>>
>> *Recipient Data: *
>> *Time Finished:* 2025-03-25 13:31:54 MDT
>> *IP:* 166.199.97.13
>> *ResponseID:* R_74eBNxdebday4VK
>> *Link to View Results:* Click Here
>> <https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/M3tJ6w49eHsGu_jbVqVUfnwc_XzpkotUedieDtQk7_PFUMTZ0eqKS9A-AR9sfvaRZc3Rc3QDztrMlK_amHGn9kR5lwj5Qinl_3pbAQ0RKVGQkCXyuZqTZKsqeJ7yt4K5nXe6gOp9zcwzIcJxu69Mcjgo6UZmIXJofQ3anibKBmW6F1UpFh2rchibEvWUg66TtPePpIaxopaSr6fCRoF_I4vWbxU3tJrOIRFmLEFyehTUP1OfiVcMwQntKR_ep_OdtlJXW7L9syT7DxDjegWGMgcdz9XMqfUUQLW1RBB2rM1hfAp6QPi_Pn9b3KO_DUgLmy60UqIMK7k6zYpxXS5vWA>
>> *URL to View Results:*
>> https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/M3tJ6w49eHsGu_jbVqVUfnwc_XzpkotUedieDtQk7_PFUMTZ0eqKS9A-AR9sfvaRZc3Rc3QDztrMlK_amHGn9kR5lwj5Qinl_3pbAQ0RKVGQkCXyuZqTZKsqeJ7yt4K5nXe6gOp9zcwzIcJxu69Mcjgo6UZmIXJofQ3anibKBmW6F1UpFh2rchibEvWUg66TtPePpIaxopaSr6fCRoF_I4vWbxU3tJrOIRFmLEFyehTUP1OfiVcMwQntKR_ep_OdtlJXW7L9syT7DxDjegWGMgcdz9XMqfUUQLW1RBB2rM1hfAp6QPi_Pn9b3KO_DUgLmy60UqIMK7k6zYpxXS5vWA
>> ------------------------------
>>
>> *Response Summary:*
>>
>> PLEASE SELECT PERMIT TYPE:
>> Facilites maintenance and other small projects
>>
>> 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:
>> Does not apply
>>
>> WORK ON ENCLOSED EQUIPMENT:
>> Does not apply
>>
>> HOT WORK BEING PERFORMED BY:
>> UC Riverside employee
>>
>> HOT WORK OPERATOR:
>> Name Daniel mendez
>> Company/Department Sheetmetal shop
>> Mobile Phone Number (###-###-####) 9516084082
>>
>> FIRE WATCH:
>> Name Jesse Guzman
>> Company/Department Plumbing shop
>> Mobile Phone Number (###-###-####) 9516084087
>>
>> JOB TIME FRAME:
>> Start date 03/25/2025
>> Start Time 12:30pm
>> End Date 03/25/2025
>> End time 2:30pm
>>
>> LOCATION OF HOT WORK (BUILDING, FLOOR, ROOM, ETC.)
>> Steam plant
>>
>> Project/WO Number:
>> 86731
>>
>> PROJECT/JOB DESCRIPTION:
>> Weld cover bracket for shaft in the cooling tower
>>
>> FACILITIES SUPERVISOR OR UCR PROJECT MANAGER SUPERVISING THIS JOB:
>> Name Cory Gryniuk
>> Phone Number 9517436159
>> Email Cory.gryniuk at ucr.edu
>>
>> HOT WORK PERMIT REQUESTOR:
>> Name Daniel mendez
>> Department/Contractor Company Sheetmetal shop
>> Phone Number 9516084082
>> Email Address Dmendez at ucr.edu
>>
>>
>>
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