Hot Work Permit FILLABLE Form Procedures
October 2016
In order to quickly process your requests to perform hot work, the Hot Work Permit is now a Microsoft Word fillable form. By using this form, your complete and accurate information will be clearly and rapidly communicated to expedite its approval. Let's minimized delays caused by incomplete forms requiring follow-up questions!
This document consists of the following four (4) pages:
Page 1: Hot Work Permit FILLABLE Form Procedures (It’s this page that you are now reading!)
Page 2: Hot Work Permit Guidelines
Page 3: Hot Work Permit – Sample of a completed form
Page 4: Hot Work Permit form (fillable fields have a red border )
a) To ensure that your information is readable, please complete this form on a computer, using Microsoft Word.
- Only in emergencies will readable handwritten forms and photos of form be accepted.
b) Open the attached Hot Work Permit fillable form
- Close the "Restrict Formatting and Editing" task pane (see image below)
c) Enter text in all of the fields
d) Check all of the x boxes that apply
e) Print out the form and sign your name in the "SIGNATURE OF SUP OR DESIGNEE" field
f) Send your completed form – Email a PDF file or Fax
- Scan your signed form as an Adobe Acrobat PDF file
- Name your PDF file: Use the following format when naming your PDF file:
[YR-MO-Day] Hot Work Permit – [Concession] [nearest Gate #] – [Contractor] – [Repairs]
2016-04-30 Hot Work Permit – Starbucks G9 – Draco Const – Compressor Repairs
- Email the PDF file to the six (6) addresses shown on Page 2: Hot Work Permit Guidelines
Please make certain that your authorized staff members and select contractors familiarize themselves with this document as soon as possible. Don't wait until you have a need for emergency repairs requiring Hot Work!
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Hot Work Permit FILLABLE Form Procedures
October 2016
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Hot Work Permit Guidelines
Overview
This Hot Work Permit is required for any job(s) being done by Contractors at the Oakland International Airport, which may involve open flames or heat and/or spark producing operations such as but not limited to welding, cutting, brazing or grinding. The attached permit must be completed by a Competent Hot Work Supervisor (CHWS) or Designee and be posted at the site. Please reference NFPA 51B for definition of a Competent Hot Work Supervisor.
All employees intending to conduct any hot work within the AOA must follow the guidelines set forth in the Airport Bulletin No 07-108 (Hot Work on the Airport) and must provide prior notification to Airside Operations Manager on Duty before actual hot work begins.
PROCEDURE
1. This permit must be completed and distributed at least 2 business days (or no less than 24 hours for special emergency related circumstances) prior to work commencement to allow for adequate distribution and preparation by Airport Personnel. Note: For the purpose of this procedure, “emergency” is defined as an unplanned, uncontrolled event that (if not dealt with) could cause service outage of primary security and/or safety systems and/or communication systems, that could threaten the life and safety of employees, tenants, contractors and the public (passengers).
2. Print a hard copy of Permit and complete all boxes on the permit before sending to the distribution list. (Note: The Permit is not valid until all boxes are complete). Post the completed permit at the site where work is taking place.
3. Once the Permit is complete, please send electronically (scanned copies are OK) via e-mail to the following addresses:
o Airside Operations -
o Airport Building Services –
o Airport Utilities –
o Airport Landside Ops –
o Health and Safety –
o Airport Properties –
4. Contact the MOD (510-563-3361) prior to start of any hot work in public areas (i.e. restaurants, concessions locations, etc.) and areas critical to airline operations (i.e. jet bridge, ticketing and baggage areas, etc.).
5. If work has been cancelled or area conditions change prior to work commencement or when job is complete please notify:
o Above email addresses
6. Prior to leaving site, ensure that the area is clean and no debris and/or construction related supplies or materials are left behind.
Conclusion
This permit and guidelines were created to promote and maintain a level of safety and fire prevention here at Oakland International Airport, strict enforcement is expected. Contractors that do not adhere to the permit conditions and/or these guidelines can and will be asked to leave the site and work stopped until conditions and guidelines are met.
For questions regarding these guidelines and the attached permit please contact the Port Safety Department at (510) 627-1469 or
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PERMIT IS NOT VALID UNLESS ALL BOXES ARE COMPLETE.
If the required precautions cannot be met, Hot Work is not permitted.
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CONTRACTOR NAME:Click here to enter text
DATE:
??/??/16 / PORT CONTACT NAME & CELL NUMBER:
Doug Johnson
AREA/LOCATION/BUILDING or ROOM:
Click here to enter text.
☐ In Terminal or ☐ AOA
NATURE OF JOB – (Please provide specific details of the job)
This Hot Work involves the following (check all that apply):
☐Open Flames; ☐ Heat and/or Spark Producing Operations; Not limited to: ☐Welding; ☐Cutting; ☐Brazing; ☐Grinding
Click here to enter text describing your Hot Work.
NAME OF PERSON DOING HOT WORK
Click here to enter text.
DIRECT SUPERVISOR OR DESIGNEE
Name (Print)
Click here to enter text. / Cell Phone #
( ) -
THIS PERMIT EXPIRES AFTER JOB COMPLETION OR ONE SHIFT WHICHEVER COMES FIRST.
PERMIT
ISSUED / DATE
??/??/16 / TIME
??:00 ☐AM or ☐PM
PERMIT EXPIRES / DATE
??/??/16 / TIME
??:00 ☐AM or ☐PM
I verify the above location has been examined, the precautions checked on the Required Precautions Checklist have been taken to prevent fire, and permission is authorized for work.
SIGNATURE OF SUP OR DESIGNEE
X: ______
REQUIRED PRECAUTIONS CHECKLIST
☐YES - Available sprinklers, hose streams, and extinguishers are in service and operable?
☐ YES - Hot work equipment in good repair?
Requirements within 35ft of work
☐ YES ☐ N/A - Flammable liquids, dust, lint and oil deposits removed?
☐ YES ☐ N/A - Explosive atmosphere in area eliminated?
☐ YES ☐ N/A - Floors swept clean of combustibles?
☐ YES ☐ N/A - Combustible floors wet down, covered with damp sand or fire- resistant sheets?
☐ YES ☐ N/A - Remove other combustibles where possible. Otherwise protect with fire-resistant tarpaulins, screens or shields?
☐ YES ☐ N/A -All wall and floor openings covered?
☐ YES ☐ N/A -Fire-resistant tarpaulins suspended beneath elevated hot work?
Work on walls or ceilings/enclosed equipment
☐ YES ☐ N/A -Construction is noncombustible and without combustible covering or insulation?
☐ YES ☐ N/A - Combustibles on other side of walls moved away?
☐ YES ☐ N/A - No danger exists by conduction of heat into another room or area?
☐ YES ☐ N/A - Enclosed equipment cleaned of all combustibles?
☐ YES ☐ N/A - Containers purged of flammable liquids and vapors?
Fire watch/hot work area monitoring.
☐ YES -Fire watch will be provided during and continuously for 30 minutes after work, including during any work breaks?
☐ YES - Fire watch is supplied with suitable extinguishers?
☐ YES - Fire watch is trained in use of this equipment and in sounding alarm?
☐ YES ☐ N/A - Fire watch may be required for adjoining areas, above and below?
☐ YES - Hot work area inspected 30 minutes after job is completed?
☐ YES ☐ N/A – Is there ample ventilation to remove smoke or vapor from work area?
Other Precautions
Is work being done outside between Gates 25-28?
☐YES ☐NO –
Is the Fire Alarm system affected?
☐YES ☐ NO ☐ Don’t Know
Is the area protected with smoke or heat detection?? ☐ YES ☐ NO ☒ Don’t Know
Note: If Yes or Don’t Know is checked above, Contact Airport Utilities at least 2 business days (non-emergency) prior to conducting any hot work. (See Hot Work Permit Guidelines)
Distribution List:
Airside Operations; Airport Utilities;
Landside Operations; Airport Bldg. Services;
Health and Safety; Airport Properties
Hot Work Time Duration:
Actual START time that Hot Work begins and END time:
Actual END Time: ??:00 AM/PM
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