<div dir="ltr"><div dir="ltr"><div><div class="gmail_default" style="font-family:tahoma,sans-serif"><i><font size="4">Once Job is complete: </font></i></div><div class="gmail_default" style="font-family:tahoma,sans-serif"><em style="color:rgb(0,0,255);font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">Select <u>reply all</u> and complete the below information before sending.</span></em></div> <br><span style="font-size:13px"><strong>JOB COMPLETED ON (Please specify DATE and TIME):</strong></span><br> <div><span style="font-size:13px"><strong>SUBMITTED BACK TO EH&S (DATE):<br><br>SUBMITTED BY:</strong></span><br></div><br clear="all"></div><div><div dir="ltr" class="gmail_signature"><div dir="ltr"><font size="4"><b>Tracy Stark</b></font><div>Safety Engineer</div><div>UCR Environmental Health & Safety</div><div><a href="mailto:tracy.stark@ucr.edu" target="_blank">tracy.stark@ucr.edu</a></div><div>(951) 827-5118</div><div><a href="https://calendar.app.google/ARaUNPsZHLaZngta9" target="_blank">Book time with me on Zoom or in-person here.</a></div></div></div></div><br></div><br><div class="gmail_quote gmail_quote_container"><div dir="ltr" class="gmail_attr">On Mon, Aug 4, 2025 at 2:20 PM Hot Work Program <<a href="mailto:noreply@qemailserver.com">noreply@qemailserver.com</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div> <img alt="Graphic.php?IM=IM_8HvGTwJPt7awyvX" src="https://ucriverside.az1.qualtrics.com/CP/Graphic.php?IM=IM_8HvGTwJPt7awyvX" style="width: 180px; height: 45px;"><br>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong>HOT WORK PERMIT REQUEST<br>
FACILITIES SERVICES AND OTHER DEPARTMENTS</strong><br>
-----------------------------------------------------------------------------------------------------</span><br>
<span style="font-size:13px"><strong>HOT WORK IS BEING PERFORMED BY: </strong>UC Riverside employee<br>
<br>
<strong>PERMIT REQUESTOR:</strong> Daniel mendez<br>
<strong>DEPARTMENT: </strong>Facilities Sheetmetal shop </span></span>
<div><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong>PHONE NUMBER:</strong> 9516084082<br>
<strong>EMAIL: </strong><a href="mailto:Dmendez@ucr.edu" target="_blank">Dmendez@ucr.edu</a></span></span></div>
<br>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong>PROJECT MANAGER/SUPERVISOR: </strong>Cory Gryniuk <br>
<strong>PHONE NUMBER: </strong>9517436159<br>
<strong>EMAIL: </strong><a href="mailto:Cory.Gryniuk@ucr.edu" target="_blank">Cory.Gryniuk@ucr.edu</a><br>
<br>
<strong>PERSON PERFORMING HOT WORK: </strong>Daniel mendez<br>
<strong>COMPANY/DEPARTMENT: </strong>Facilities Sheetmetal shop <br>
<strong>PHONE NUMBER: </strong>9516084082<br>
<br>
<strong>PERSON PERFORMING FIRE WATCH: </strong>Ryan <br>
<strong>COMPANY/DEPARTMENT: </strong>Facilities Sheetmetal shop <br>
<strong>PHONE NUMBER: </strong>9516084061<br>
----------------------------------------------------------------------------------------------------------------------------- </span></span>
<div><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong><span style="background-color:rgb(211,211,211)">JOB DETAILS</span></strong></span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> <br>
<strong>JOB START DATE: </strong>08/05/2025 6:15 Am<br>
<strong>JOB END DATE: </strong>08/05/2025 2:15 PM<br>
<br>
<strong>LOCATION - BUILDING/FLOOR/ROOM</strong>: Rivera library side patio<br>
<br>
<strong>JOB DESCRIPTION: </strong><br>
Welding bracket for gate closure.</span><br>
<span style="font-size:13px"> </span><br>
<br>
<span style="font-size:16px"><strong>THE FOLLOWING PRECAUTIONS HAVE BEEN ACKNOWLEDGED AND WILL BE IN PLACE WHENEVER POSSIBLE (FOR EXCEPTIONS - SEE COMMENTS BELOW)</strong></span><br>
<span style="font-size:13px"> <br>
<strong>General:</strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px">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></span></div>
<br>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> <strong>Within 35 feet (11 meters) of work: </strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px">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></span></div>
<br>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong>Fire Watch/Hot Work area monitoring: </strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px">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></span></div>
<br>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong>Work on walls, ceilings and/or roofs:</strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px">Does not apply<br>
</span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> <strong>Work on enclosed equipment:</strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px">Does not apply</span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> <br>
<strong>OTHER PRECAUTION(S) TAKEN (IF APPLICABLE): </strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> </span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> <br>
<strong>COMMENTS (WHY PRECAUTION(S) CANNOT BE PUT INTO PLACE): </strong></span></span>
<div style="margin-left:40px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"> </span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"> <span style="font-size:13px"> </span> <span style="font-size:13px"> </span></span>
<div><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="font-size:13px"> </span><em><span style="font-size:13px"> <br>
End of Request</span><br>
-----------------------------------------------------------------------------------------------------------------------------</em><br>
<span style="font-size:16px"><span style="background-color:rgb(211,211,211)">EH&S Approval </span></span><span style="font-size:19px"><span style="background-color:rgb(211,211,211)"> </span></span></strong></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"> <span style="font-size:16px"><em><strong>------------------------------------------------------------------------------------------------------</strong></em></span><br>
<br>
<span style="font-size:13px"><strong>EH&S APPROVAL: </strong><br>
<br>
<strong>PERMIT START (DATE): </strong><br>
<br>
<strong>PERMIT EXPIRES (DATE): </strong><br>
<br>
<strong>APPROVAL SENT TO FS (DATE): </strong><br>
<br>
<strong>COMMENTS:</strong><br>
</span><br>
<span style="font-size:16px"><em><strong>------------------------------------------------------------------------------------------------------</strong></em></span></span>
<div><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:rgb(211,211,211)"><strong>Send w</strong></span></span><span style="font-size:19px"><strong><span style="background-color:rgb(211,211,211)"><span style="font-size:16px">ork completion notice to <a href="mailto:hotwork@lists.ucr.edu" target="_blank">hotwork@lists.ucr.edu</a> </span> </span></strong></span><br>
<strong><em><span style="font-size:16px">------------------------------------------------------------------------------------------------------</span></em></strong><br>
<span style="color:rgb(0,0,255)"><em><span style="font-size:16px"><span class="gmail_default" style="font-family:tahoma,sans-serif"></span>Select reply and complete the below information before sending.</span></em></span></span></div>
<span style="font-family:Arial,Helvetica,sans-serif"> <br>
<span style="font-size:13px"><strong>JOB COMPLETED ON (Please specify DATE and TIME):</strong></span></span><br>
<div><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:13px"><strong>SUBMITTED BACK TO EH&S (DATE):<br>
<br>
SUBMITTED BY:</strong></span></span><br>
<br>
</div>
<br>
<br>
<hr>
<br>
<b>Recipient Data: </b><br>
<b>Time Finished:</b> 2025-08-04 15:20:08 MDT<br>
<b>IP:</b> 169.235.64.133<br>
<b>ResponseID:</b> R_7CsGZYmciQyBE5Q <br>
<b>Link to View Results:</b> <a href="https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/Ke5YTeGJy5J1AHodKJLtFZmYKxza343zTpHg0dIDihP6Z-Z-LzQXh7LAoa20W0oS8RldHTYsI4HsK3tA9cdjpONrUqIEgraBggH7Mi5PCXXIINs3_M0dL4teX8pf5fi2G5s6mC901OM4X3yRYNu4L-CFil-ko0cfIk5ZJLhTCLWluopeEx1B_cjJBpC0Eoh9WQzrGOtVprG3_3tqzyQheRj4asAs8sSAKv8vfjiilB5ENxJmtzOFKUneGjdw9_4w30oZRJV7URiyh16H2drQYJBEI5wqHBl8RWyGLkSdoSeWtEkHiCp0DNA-4H65CNCJyMRsn8zEWqiuZkcy92oCcw" target="_blank">Click Here</a><br>
<b>URL to View Results:</b> <a href="https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/Ke5YTeGJy5J1AHodKJLtFZmYKxza343zTpHg0dIDihP6Z-Z-LzQXh7LAoa20W0oS8RldHTYsI4HsK3tA9cdjpONrUqIEgraBggH7Mi5PCXXIINs3_M0dL4teX8pf5fi2G5s6mC901OM4X3yRYNu4L-CFil-ko0cfIk5ZJLhTCLWluopeEx1B_cjJBpC0Eoh9WQzrGOtVprG3_3tqzyQheRj4asAs8sSAKv8vfjiilB5ENxJmtzOFKUneGjdw9_4w30oZRJV7URiyh16H2drQYJBEI5wqHBl8RWyGLkSdoSeWtEkHiCp0DNA-4H65CNCJyMRsn8zEWqiuZkcy92oCcw" target="_blank">https://ucriverside.pdx1.qualtrics.com/apps/single-response-reports/reports/Ke5YTeGJy5J1AHodKJLtFZmYKxza343zTpHg0dIDihP6Z-Z-LzQXh7LAoa20W0oS8RldHTYsI4HsK3tA9cdjpONrUqIEgraBggH7Mi5PCXXIINs3_M0dL4teX8pf5fi2G5s6mC901OM4X3yRYNu4L-CFil-ko0cfIk5ZJLhTCLWluopeEx1B_cjJBpC0Eoh9WQzrGOtVprG3_3tqzyQheRj4asAs8sSAKv8vfjiilB5ENxJmtzOFKUneGjdw9_4w30oZRJV7URiyh16H2drQYJBEI5wqHBl8RWyGLkSdoSeWtEkHiCp0DNA-4H65CNCJyMRsn8zEWqiuZkcy92oCcw</a><br>
<hr>
<br>
<b>Response Summary:</b> <br><br>
PLEASE SELECT PERMIT TYPE:<br> Facilites maintenance and other small projects<br><br>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.<br> 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<br><br>WITHIN 35 FEET (11 METERS) OF HOT WORK SITE:<br> 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<br><br>FIRE WATCH/HOT WORK AREA MONITORING:<br> Fire watch will be provided during and for at least 30 minutes after work stops
(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<br><br>WORK ON WALLS, CEILINGS, AND/OR ROOFS:<br> Does not apply<br><br>WORK ON ENCLOSED EQUIPMENT:<br> Does not apply<br><br>HOT WORK BEING PERFORMED BY:<br> UC Riverside employee<br><br>HOT WORK OPERATOR:<br> Name Daniel mendez<br> Company/Department Facilities Sheetmetal shop <br> Mobile Phone Number (###-###-####) 9516084082<br><br>FIRE WATCH:<br> Name Ryan <br> Company/Department Facilities Sheetmetal shop <br> Mobile Phone Number (###-###-####) 9516084061<br><br>JOB TIME FRAME:<br> Start date 08/05/2025<br> Start Time 6:15 Am<br> End Date 08/05/2025<br> End time 2:15 PM<br><br>LOCATION OF HOT WORK (BUILDING, FLOOR, ROOM, ETC.)<br> Rivera library side patio<br>
<br>Project/WO Number:<br> 95882<br>
<br>PROJECT/JOB DESCRIPTION:<br> Welding bracket for gate closure.<br>
<br>FACILITIES SUPERVISOR OR UCR PROJECT MANAGER SUPERVISING THIS JOB:<br> Name Cory Gryniuk <br> Phone Number 9517436159<br> Email <a href="mailto:Cory.Gryniuk@ucr.edu" target="_blank">Cory.Gryniuk@ucr.edu</a><br><br>HOT WORK PERMIT REQUESTOR:<br> Name Daniel mendez<br> Department/Contractor Company Facilities Sheetmetal shop <br> Phone Number 9516084082<br> Email Address <a href="mailto:Dmendez@ucr.edu" target="_blank">Dmendez@ucr.edu</a><br><br><br>
</div></blockquote></div></div>