Hot Work Permit Request

Please complete the Recreational Fire Request form for any other type of open flame / fire requests. Fire Alarm Disconnects are required for all instances of welding, or any other hot work which may cause nuisance alarms

A. Proposal

To be completed by the person responsible for carrying out the work
The above location has been examined and the precautions listed on this form below have been complied with as indicated.

B. Agreement

MM slash DD slash YYYY
Start Time(Required)
:
End Time(Required)
:

C. Fire Watch

The work area and all adjacent areas to which sparks and heat may have spread (such as floors below/above and areas on the sides of walls) shall be inspected following completion of the work(Required)

D. Procedure for Hot Work permits

This hot work permit is required for any temporary operation involving open flames or sparks. This involves but is not limited to: brazing, cutting, grinding, soldering, thawing pipes, torch-applied roofing, and welding.
1. NC State Fire and Life is approving this permit and the requester and responsible parties agree to the safety requirements and expectations as listed below. 5. Upon completion of this permit application, a checklist regarding fire protection measures, safety requirements and safe use of equipment is required to be completed.
2. A permit is required prior to starting work. This should be done on every occasion that hot work of any type is undertaken within or on the fabric of established buildings or any structures in the open. This procedure also applies to construction sites. 6. If Fire and Life Safety is not satisfied with the arrangements, further measures may be requested. A pre-check inspection is required by the responsible party listed in the permit application. If trained personnel will not be available to make this check (for example in the case of a permit issued late in the day) work must be rescheduled. A fire watch is required for at least 30 minutes after the work is complete.
3. A Hot work permit should not be issued without considering the significance of any other permits to work in the vicinity, or adjacent manufacturing processes which may involve the use of flammable liquids or gasses. 7. The hot work permit should be printed and accessible on site for those who may wish to inspect the site of work or perform spot checks, to ensure that conditions have been met and that work is complete before the hot work permit expires.
4. A Hot work permit should also be issued for a specific task that is undertaken in a clearly identified area. Hot work permits should not be issued for more than a 24 hour period.

E. Hot work permit checklist

Sprinklers and smoke detectors must be covered and disabled.(Required)
At least one suitable extinguisher will be immediately available. Both the personnel undertaking the work and providing the fire watch are trained in their use.(Required)
Personnel involved with the work and providing the fire watch are familiar with the means of escape and method of initiating an alarm/calling 911 or 919-515-3000 for emergency assistance.(Required)
Precautions within 35 feet (minimum) of the work
Combustible materials will be removed from the area. Where materials cannot be removed, protection will be provided by fire retardant tarps or metal shields.(Required)
Flammable liquids will be removed from the area.(Required)
Floors and surfaces will be swept clean of combustible dust or debris.(Required)
Combustible floors will be covered with overlapping sheets of non-combustible material or wetted and liberally covered with sand. All openings and gaps.(Required)
Protection (metal shields or fire retardant tarps) will be provided for: Walls, partitions, and ceilings of combustible construction or surface finish and all holes and other openings in walls, partitions, and ceilings through which sparks could pass.(Required)
Combustible materials will be moved away from the far side of walls or partitions where heat could be conducted, especially where these incorporate metal.(Required)
Enclosed equipment (tanks, containers, dust collectors, etc.) will be emptied and tested, or is known to be free of flammable concentration of vapor or dust.(Required)
Equipment
Equipment for hot work will be checked and found to be in good repair.(Required)
Gas cylinders will be kept at least 10 feet from the burner, have been secured in a vertical position, fitted with a regulator and flashback arrestor.(Required)
Hazardous materials will be removed from the hot work location as soon as work is completed.(Required)
Any lit tar boilers will not be left unattended and appropriately monitored (NC Fire Code 303.4)(Required)

F. Compliance

Please type your initials.