UMBC - Environmental Safety and Health

Hot Works Permit

University of Maryland Baltimore County

Prior to starting any job, task, or operation associated with hot work (as defined by the production of heat, sparks, open flames and/or smoke), the following conditions must be met:

This hot work permit is completely filled out and signed by the operation supervisor who is competent with regard to Hot Work.

The permit is submitted 72 business hours prior to the Permit Request Effective Date unless explicit permission is granted by UMBC ESH.

The completed permit must be clearly posted at the operation site (Upon submittal a copy of the signed permit will be forwarded to the email address listed on the form, this copy can then be printed)

If for any reason the permit is not fully completed or the precautions listed under this permit can not be met, hot work is strictly prohibited.

Please note that this form may not be compatible with all browsers or mobile devices. If you are unable to submit this form please print out or otherwise transcribe all of the required information and submit it to UMBC ESH at esh@umbc.edu. Please call (410) 455 2918 or Email esh@umbc.edu for questions or concerns.

IN CASE OF FIRE, DIAL 911

Employee Information

First Name*

Last Name*

Email*

Phone*

Fax

Operations Supervisor First Name*

Operations Supervisor Last Name*

Request Information

Company/Contractor Name*

Type

Work Order No

Building where work will occur

Floor or Room where work will occur*

Nature of Work*

Hot Work Operator Name(s)*

Notes

Permit Date

Permit Request Effective Date*

Permit Request Expiration Date*

Permit Request Start Time*

Permit Request End Time*

You must agree to adhere to the following precautions by checking each item.


	I agree
Appropriate arrangements have been made with UMBC Work Control Center to prevent the accidental activation of fire detection and alarm systems.
A responsible fire watcher has been assigned to watch for dangerous sparks in area, as well as floors above and below and will remain on the job site for 60 minutes after completion of hot work.
All equipment to be used has been inspected and is in good repair.
Appropriate fire extinguishing equipment is within 10 ft. of work site. (company/contractor provides their own fire extinguishing equipment)
Floor openings within 35 feet are tightly covered.
Floors and surrounding area are clear of combustible materials within 35 feet of the work area.
Materials that cannot be moved are protected with noncombustible material or cover.
The sprinkler system, where provided, is in service.
There are no flammable liquids, vapors, dusts, lints OR equipment containing such materials in the work area.

I verify the information on this hot work permit is correct and, furthermore, that the above location has been examined for the precautions listed on this permit to prevent fire. Appropriate fire extinguishing equipment is available within 10 ft. of work site