[Hotwork] Approved: Hot Work Permit Request - Facilities Services and Other Departments
Tracy Stark
tracy.stark at ucr.edu
Fri May 2 07:55:59 PDT 2025
Approved. Thank you, Daniel.
*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 Fri, May 2, 2025 at 7:37 AM 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: *UC Riverside Sheetmetal shop
> *PHONE NUMBER: *9516084082
>
> *PERSON PERFORMING FIRE WATCH: *Jesse
> *COMPANY/DEPARTMENT: *Ucr plumbing shop
> *PHONE NUMBER: *9516084087
>
> -----------------------------------------------------------------------------------------------------------------------------
> *JOB DETAILS*
>
> *JOB START DATE: *05/03/2025 7:30 am
> *JOB END DATE: *05/04/2025 8:29 AM
>
> *LOCATION - BUILDING/FLOOR/ROOM*: Plant research 1
>
> *JOB DESCRIPTION: *
> Weld 3” steam pipe
>
>
> *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*
>
> *PERMIT START (DATE): 5/3/25*
>
> *PERMIT EXPIRES (DATE): 5/5/25*
>
> *APPROVAL SENT TO FS (DATE): 5/2/25*
>
> *COMMENTS:*
>
>
> *------------------------------------------------------------------------------------------------------*
> *Send w**ork completion notice to hotwork at lists.ucr.edu
> <hotwork at lists.ucr.edu> *
>
> *------------------------------------------------------------------------------------------------------*
> *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:* 2025-05-02 08:37:41 MDT
> *IP:* 107.127.56.97
> *ResponseID:* R_7lvhVrneBKP5wHv
> *Link to View Results:* Click Here
> <https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/Sq36K27QZJlogkw9iNT3uY91SSG6HI5QaskdcgpywCHRJeVC4GFwphJasul0YzycglsJNi7zDj9XPUZY8ghPgQEsunVztekBtHsaUXNiWgnz63E5xyoQA8nFUkCb3zhVUxVfIIx48ppikGSR65Pt5FBqQmssZ7ujXp7wjQ4cdrhyQdWcjLEik1XRZNOK4quJOJhrTPDK-8UhR_a6WFmy2nTyemeoiIBnYVNqHgsVrcJiLFwYq42X7RPzo9FRoq_wBY0kxkOSBkeM_M5uPlmSRkNabSnxviwSiVlZPlj0wnJxuNR9KYFQfGOaOs48vJy3IPthKG4q7zkQm0qQSABTDg>
> *URL to View Results:*
> https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/Sq36K27QZJlogkw9iNT3uY91SSG6HI5QaskdcgpywCHRJeVC4GFwphJasul0YzycglsJNi7zDj9XPUZY8ghPgQEsunVztekBtHsaUXNiWgnz63E5xyoQA8nFUkCb3zhVUxVfIIx48ppikGSR65Pt5FBqQmssZ7ujXp7wjQ4cdrhyQdWcjLEik1XRZNOK4quJOJhrTPDK-8UhR_a6WFmy2nTyemeoiIBnYVNqHgsVrcJiLFwYq42X7RPzo9FRoq_wBY0kxkOSBkeM_M5uPlmSRkNabSnxviwSiVlZPlj0wnJxuNR9KYFQfGOaOs48vJy3IPthKG4q7zkQm0qQSABTDg
> ------------------------------
>
> *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 UC Riverside Sheetmetal shop
> Mobile Phone Number (###-###-####) 9516084082
>
> FIRE WATCH:
> Name Jesse
> Company/Department Ucr plumbing shop
> Mobile Phone Number (###-###-####) 9516084087
>
> JOB TIME FRAME:
> Start date 05/03/2025
> Start Time 7:30 am
> End Date 05/04/2025
> End time 8:29 AM
>
> LOCATION OF HOT WORK (BUILDING, FLOOR, ROOM, ETC.)
> Plant research 1
>
> Project/WO Number:
> 90070
>
> PROJECT/JOB DESCRIPTION:
> Weld 3” steam pipe
>
> 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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