UH Victoria Hot Work Application and Permit

A hot work permit is required in advance of any work requiring heat or open flame to complete within a facility owned, leased or managed by UHV.  Hot work procedures include welding, torch cutting, grinding, brazing, flame soldering, thawing pipes with torches, and other work where there is potential for fire. If you are requesting this permit, you should be working from either a work order, university purchase order, departmental order or a signed contract.  Do not proceed with work if  an order or contract has not been issued.

Requestor:  (check 1)  Employee __  Contractor/Vendor __

Name of Requestor: ______________________________ Name of Company______________________
Phone: __________ Pager: _________ Cell # __________        Address (if external)____________________
Address  _____________________________

Description of Hot Work to be Performed (be specific):  _______________________________________________________________________________________


Location of Work: _________________ ______________  ______________
              Bldg      Floor           Room/Area

Start: Day ______Date:  ______Time: ____AM    PM    End: Day ______Date:  ______Time: ____AM  PM


This section is to be completed by UHV Facilities Coordinator  (Mark all blocks “Yes” or “NA”)

__   Sprinklers and fire system is operational.
__   Floors and surfaces clean of combustibles
__   Combustibles and flammable liquids protected with fire-proof tarp or removed.
__   Fireproof tarpaulins suspended beneath work to collect sparks and protect pedestrian.
__   For wall or ceiling work, combustibles moved away from opposite side.
__   For equipment work, equipment cleaned of all combustibles.
__   For equipment work, there is adequate air flow through equipment.
__   I have verified with Purchasing that a current certificate of insurance is on file for this vendor.
__   I have notified the operator to contact me immediately upon completion of this job.

__ Yes  __ No       A fire watch is required. (A fire watch is required by the University when the type of work or the work area indicates such a precaution would be prudent and reasonable to protect life and property from fire.  All hot work operations must be conducted between the hours of 8:30AM – 4:00PM Weekdays.  Any hot work outside of these times will require a University manned fire watch.  The fire watch person maintains vigilance, looking for the presence of fire or hazardous conditions within the hot work area.   After the work is complete, the fire watch will re-inspect the area  to make it is fire safe.  Fire watch personnel should be trained in the use of ABC type fire extinguishers, familiar with the facility and/or equipment, know the procedure for sounding fire alarms, notifying building occupants in case of fire, and notifying the fire department (9-911).  If a fire should occur, the fire watch should attempt to extinguish or smother the fire using the extinguisher and/or fire tarp at the work site.)

I have personally examined the proposed hot work area and reviewed this request.  I certify that the checked precautions have been taken or will be taken prior to the start of hot work for this job unless I have noted otherwise below.  If a fire watch is not required, I will ensure that the work site operator has access to fire equipment and is aware of UHV safety protocol.



Signature of Facilities Coordinator:  _______________________________   Date: _____________________



Hot Work Permit Approved:  _______________________________________          _____________________
                                                     Facilities Coordinator or Safety and Risk Manager               Date


Final Re-Inspection by Facilities Coordinator or Fire Watch Employee

Within one hour after the hot work was completed,  I re-inspected the area including adjacent areas to which sparks and heat may have spread and found the area to be fire safe.

Signature :  ___________________________   Printed Name:_______________________  Date: _________