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<p class="MsoNormal"><b>From:</b> Hot Work Program <noreply@qemailserver.com> <br>
<b>Sent:</b> Friday, October 22, 2021 11:18 AM<br>
<b>To:</b> Tracy Kathleen Stark <tracy.stark@ucr.edu><br>
<b>Subject:</b> NEW Hot Work Permit Request - Facilities Services and Other Departments<br>
<b>Importance:</b> High<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"> <img id="_x0000_i1025" src="https://ucriverside.az1.qualtrics.com/CP/Graphic.php?IM=IM_8HvGTwJPt7awyvX" alt="Graphic.php?IM=IM_8HvGTwJPt7awyvX"><br>
<strong><span style="font-size:12.0pt;font-family:"Arial",sans-serif">HOT WORK PERMIT REQUEST</span></strong><b><span style="font-size:12.0pt;font-family:"Arial",sans-serif"><br>
<strong><span style="font-family:"Arial",sans-serif">FACILITIES SERVICES AND OTHER DEPARTMENTS</span></strong></span></b><span style="font-size:12.0pt;font-family:"Arial",sans-serif"><br>
-----------------------------------------------------------------------------------------------------</span><span style="font-family:"Arial",sans-serif"><br>
</span><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">HOT WORK IS BEING PERFORMED BY:
</span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Contractor under UC Riverside Facilities Services or other department supervision (small renovation or repairs)<br>
<br>
<strong><span style="font-family:"Arial",sans-serif">PERMIT REQUESTOR:</span></strong> Jennifer Reising<br>
<strong><span style="font-family:"Arial",sans-serif">DEPARTMENT: </span></strong>Botany and Plant Sciences</span>
<o:p></o:p></p>
<div>
<p class="MsoNormal"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">PHONE NUMBER:</span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> 9518275133<br>
<strong><span style="font-family:"Arial",sans-serif">EMAIL: </span></strong><a href="mailto:jreising@ucr.edu">jreising@ucr.edu</a></span><o:p></o:p></p>
</div>
<p class="MsoNormal"><br>
<strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">PROJECT MANAGER/SUPERVISOR:
</span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Ken Grombacher<br>
<strong><span style="font-family:"Arial",sans-serif">PHONE NUMBER: </span></strong>951-827-4370<br>
<strong><span style="font-family:"Arial",sans-serif">EMAIL: </span></strong><a href="mailto:kenneth.grombacher@ucr.edu">kenneth.grombacher@ucr.edu</a><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">PERSON PERFORMING HOT WORK: </span>
</strong>Carlos Medina-Rojas<br>
<strong><span style="font-family:"Arial",sans-serif">COMPANY/DEPARTMENT: </span></strong>Scientific Services
<br>
<strong><span style="font-family:"Arial",sans-serif">PHONE NUMBER: </span></strong>619-517-2688<br>
<br>
<strong><span style="font-family:"Arial",sans-serif">PERSON PERFORMING FIRE WATCH: </span></strong>Matt Ulrich<br>
<strong><span style="font-family:"Arial",sans-serif">COMPANY/DEPARTMENT: </span></strong>UC Riverside
<br>
<strong><span style="font-family:"Arial",sans-serif">PHONE NUMBER: </span></strong>909-525-7744<br>
----------------------------------------------------------------------------------------------------------------------------- </span>
<o:p></o:p></p>
<div>
<p class="MsoNormal"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif;background:lightgrey">JOB DETAILS</span></strong><o:p></o:p></p>
</div>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> <br>
<strong><span style="font-family:"Arial",sans-serif">JOB START DATE: </span></strong>10/26/2021 8:30 AM<br>
<strong><span style="font-family:"Arial",sans-serif">JOB END DATE: </span></strong>10/26/2021 9:30 AM<br>
<br>
<strong><span style="font-family:"Arial",sans-serif">LOCATION - BUILDING/FLOOR/ROOM</span></strong>: Genomics building 4th floor room 4112A <br>
<br>
<strong><span style="font-family:"Arial",sans-serif">JOB DESCRIPTION: </span></strong><br>
Brazing refrigerant coil for deli fridge</span><span style="font-family:"Arial",sans-serif"><br>
</span><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> </span><span style="font-family:"Arial",sans-serif"><br>
<br>
</span><strong><span style="font-size:12.0pt;font-family:"Arial",sans-serif">THE FOLLOWING PRECAUTIONS HAVE BEEN ACKNOWLEDGED AND WILL BE IN PLACE WHENEVER POSSIBLE (FOR EXCEPTIONS - SEE COMMENTS BELOW)</span></strong><span style="font-family:"Arial",sans-serif"><br>
</span><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> <br>
<strong><span style="font-family:"Arial",sans-serif">General:</span></strong></span>
<o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Available sprinklers, hose streams, and fire extinguishers are in service and operable<br>
, Hot work equipment is in good repair<br>
, Fire detection equipment protected from false activation<br>
, PPE is used to protect workers from physical and chemical hazards while hot work is being performed</span><o:p></o:p></p>
</div>
<p class="MsoNormal"><br>
<span style="font-size:10.0pt;font-family:"Arial",sans-serif"> <strong><span style="font-family:"Arial",sans-serif">Within 35 feet (11 meters) of work:
</span></strong></span><o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Flammable liquids, dust, lint, and oily deposits are removed/cleaned<br>
, Explosive atmosphere in area is eliminated<br>
, Floors are swept and clean<br>
, Combustible floors are wet down and/or covered with fire protection blankets<br>
, Other combustibles are removed when possible or else covered with fire protection blankets or metal shields<br>
, All wall and floor openings are covered<br>
, Fire protection blankets are suspended beneath work<br>
, Ducts and conveyors that might carry sparks to distant combustible materials are protected or shut down</span><o:p></o:p></p>
</div>
<p class="MsoNormal"><br>
<strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Fire Watch/Hot Work area monitoring:
</span></strong><o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Fire watch will be provided during and for at least 30 minutes after work stops<br>
(including lunch and break times)<br>
, Fire watch is supplied with suitable fire extinguishers and fire fighting equipment<br>
, Fire watch is trained in the use of fire extinguishing equipment and in sounding emergency alarm<br>
, Additional fire watch may be required in adjoining areas, above, and/or below<br>
, Fire watch will verify isolated fire detection equipment is returned to normal operation</span><o:p></o:p></p>
</div>
<p class="MsoNormal"><br>
<strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Work on walls, ceilings and/or roofs:</span></strong>
<o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Does not apply<br>
</span><o:p></o:p></p>
</div>
<p class="MsoNormal"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Work on enclosed equipment:</span></strong>
<o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif">Does not apply</span><o:p></o:p></p>
</div>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> <br>
<strong><span style="font-family:"Arial",sans-serif">OTHER PRECAUTION(S) TAKEN (IF APPLICABLE):
</span></strong></span><o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> </span><o:p></o:p></p>
</div>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> <br>
<strong><span style="font-family:"Arial",sans-serif">COMMENTS (WHY PRECAUTION(S) CANNOT BE PUT INTO PLACE):
</span></strong></span><o:p></o:p></p>
<div style="margin-left:30.0pt">
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> </span><o:p></o:p></p>
</div>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> </span><span style="font-family:"Arial",sans-serif">
</span><o:p></o:p></p>
<div>
<p class="MsoNormal"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">
</span></strong><em><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif"> </span></b></em><b><i><span style="font-size:10.0pt;font-family:"Arial",sans-serif"><br>
<em><span style="font-family:"Arial",sans-serif"> End of Request</span></em></span></i></b><b><i><span style="font-family:"Arial",sans-serif"><br>
<em><span style="font-family:"Arial",sans-serif">-----------------------------------------------------------------------------------------------------------------------------</span></em></span></i></b><b><span style="font-family:"Arial",sans-serif"><br>
</span></b><strong><span style="font-size:12.0pt;font-family:"Arial",sans-serif;background:lightgrey">EH&S Approval </span></strong><strong><span style="font-size:14.5pt;font-family:"Arial",sans-serif;background:lightgrey">
</span></strong><o:p></o:p></p>
</div>
<p class="MsoNormal"><strong><i><span style="font-size:12.0pt;font-family:"Arial",sans-serif">------------------------------------------------------------------------------------------------------</span></i></strong><span style="font-family:"Arial",sans-serif"><br>
<br>
</span><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">EH&S APPROVAL: <span style="color:#0070C0">Tracy Stark</span></span></strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif"><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">PERMIT START (DATE): <span style="color:#0070C0">
10/26/2021</span></span></strong><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">PERMIT EXPIRES (DATE): <span style="color:#0070C0">
10/27/2021</span></span></strong><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">APPROVAL SENT TO FS (DATE): <span style="color:#0070C0">
10/25/2021</span></span></strong><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">COMMENTS:</span></strong><br>
</span><span style="font-family:"Arial",sans-serif"><br>
</span><strong><i><span style="font-size:12.0pt;font-family:"Arial",sans-serif">------------------------------------------------------------------------------------------------------</span></i></strong>
<o:p></o:p></p>
<div>
<p class="MsoNormal"><strong><span style="font-size:12.0pt;font-family:"Arial",sans-serif;background:lightgrey">Send work completion notice to
<a href="mailto:hotwork@lists.ucr.edu"><span style="font-weight:normal">hotwork@lists.ucr.edu</span></a> </span></strong><strong><span style="font-size:14.5pt;font-family:"Arial",sans-serif;background:lightgrey">
</span></strong><span style="font-family:"Arial",sans-serif"><br>
</span><em><b><span style="font-size:12.0pt;font-family:"Arial",sans-serif">------------------------------------------------------------------------------------------------------</span></b></em><span style="font-family:"Arial",sans-serif"><br>
</span><em><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:blue">Select reply and complete the below information before sending.</span></em><o:p></o:p></p>
</div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"> <br>
</span><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">JOB COMPLETED ON (Please specify DATE and TIME):</span></strong><br>
<o:p></o:p></p>
<div>
<p class="MsoNormal"><strong><span style="font-size:10.0pt;font-family:"Arial",sans-serif">SUBMITTED BACK TO EH&S (DATE):</span></strong><b><span style="font-size:10.0pt;font-family:"Arial",sans-serif"><br>
<br>
<strong><span style="font-family:"Arial",sans-serif">SUBMITTED BY:</span></strong></span></b><br>
<br>
<o:p></o:p></p>
</div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><o:p> </o:p></p>
<div class="MsoNormal" align="center" style="text-align:center">
<hr size="3" width="100%" align="center">
</div>
<p class="MsoNormal"><br>
<b>Recipient Data: </b><br>
<b>Time Finished:</b> 2021-10-22 12:18:06 MDT<br>
<b>IP:</b> 138.23.178.122<br>
<b>ResponseID:</b> R_1OCbS50E0E8cOqM <br>
<b>Link to View Results:</b> <a href="https://ucriverside.az1.qualtrics.com/CP/Report.php?SID=SV_ePfBAW2lq6Aze8R&R=R_1OCbS50E0E8cOqM">
Click Here</a><br>
<b>URL to View Results:</b> <a href="https://ucriverside.az1.qualtrics.com/CP/Report.php?SID=SV_ePfBAW2lq6Aze8R&R=R_1OCbS50E0E8cOqM">
https://ucriverside.az1.qualtrics.com/CP/Report.php?SID=SV_ePfBAW2lq6Aze8R&R=R_1OCbS50E0E8cOqM</a><o:p></o:p></p>
<div class="MsoNormal" align="center" style="text-align:center">
<hr size="3" width="100%" align="center">
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