Hot Works Permit Request - Campus Departments (Other Than FM or D&CS)

NOTE: If this hot work involves UCI Facilities Management (FM) or Design & Constrction Services (D&CS), please exit this page and complete the appropriate form.

A Hot Work Permit is required for any temporary operation involving open flames or producing heat and/or sparks. This includes, but is not limited to: brazing, cutting, grinding, soldering, thawing pipe, torch applied roofing, and welding.

Instructions:

  1. Complete all required fields indicating that the proper precautions have been taken.
  2. Click “Submit”. The permit request will then be sent to EH&S for review and approval.
  3. If all precautions have been met, you will receive an approved Hot Work permit via email.
After receiving the approved permit, it must be posted at the job site until all hot work activity has been completed. When the job is finished, fill in the “Work Completion Notice” section at the bottom of the approved permit and email it to safety@uci.edu. Keep a copy of the permit for your records.

* Required fields

Precautions Checklist:

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* Requirements within 35 feet (11 meter) of work:










Work on walls, ceilings, and or roofs:





Work on enclosed equipment:






* Fire Watch/Hot Work area monitoring:>





*Hot Work is being performed by:

UC Irvine employee
Contractor under UC Irvine supervision

* Person performing Hot Work:

* Company/Department:

* Phone Number:

* Trained: Yes No

* Person performing Fire Watch:

* Company/Department:

* Phone Number:

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* End Time:

* Location - building/floor/room:

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I have verified that the above location has been examined and that all precautions selected on the checklist will be taken to prevent fire. I have also reviewed this job with my supervisor and the building/school facilities manager or EH&S representative identified below and have received permission to perform this work. They will also be copied on the email response.

THIS PERMIT REQUEST HAS BEEN REVIEWED WITH:

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AND

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PERMIT REQUESTOR INFORMATION:

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