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ARCHIVED REPORTS XR0004323
Environmental Health - Public
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3500 - Local Oversight Program
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PR0544686
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ARCHIVED REPORTS XR0004323
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Last modified
7/23/2019 11:47:02 AM
Creation date
7/23/2019 11:34:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004323
RECORD_ID
PR0544686
PE
3528
FACILITY_ID
FA0000916
FACILITY_NAME
7-ELEVEN INC #19976
STREET_NUMBER
1399
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21633034
CURRENT_STATUS
02
SITE_LOCATION
1399 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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r � • 0 • <br /> { <br /> Project Name Job# <br /> ' Hot Work Task Description <br /> Workers/Welders Conducting Hot Work <br /> PERMIT MUST BE COMPLETED IN ITS ENTIRETY AND POSTED BEFORE HOT WORK BEGINS <br /> Action Item Yes No NA <br /> Has client representative been notified of intended hot work'? <br /> Hazardous materials involved?Name <br /> Will hot work impact the general 2ublic, customers oroperations employees? <br /> 1 Will the intended hot work need to be coordinated+nmth other contractors who may be working on the <br /> site to make them aware of any hazards and the scope of work to beperformed? <br /> Have hazardous energy sources been identified isolated and locked out- <br /> ' <br /> tagged out before the start of the project? <br /> Will hot work be conducted within a confined space? <br /> All testing equipment(i a CGI oxygen meter etc)and fire fighting equipment(i e,extinguisher etc} <br /> have been checked to ensure ro r o eration and calibration before the start of this protect? <br /> Does task require a designated fire watch (30 minutes after work)? <br /> Flammable and combustible materials mthm 35 feet have been cleared or shielded <br /> All fuel sources have been identified and protected USTs ASTs sewers piping) <br /> The area has been restricted with proper barriers and signs <br /> The area has been tested to be certain that atmosphere is 0%LEL before starting hot work <br /> Flame sensitive areas and equipment(including cylinders and gas delivery lines)exposed to slag <br /> heat ands arks areprotected by flame a resistant blanket shield or removed from the area? <br /> rEscaP2 routes have been identified before starting work? <br /> Is ventilation equipment needed? Type needed <br /> ' THE FOLLOWING PROTECTIVE EQUIPMENT WILL BE REQUIRED <br /> Yes No Yes No <br /> r Welding Goggles/Shield—Tint = = Hearing Protection <br /> Safety Boots Head Protection <br /> Leather Gloves _ _ Safety Harness <br /> Supplied Air Respirator _ Welding Leathers-Top <br /> ' APR_Cartridge _ _ Welding Leathers-Bottom <br /> Cold Cut Only Method Required Hot Cut Method Allowed <br /> APPROVALS <br /> rGTI Site Manager or Site Safety Officer Date <br /> r Name of Employee Performing Hot Work Fire Watch Representative <br /> Revised 6195 <br /> i FLUOR DANIEL. GTL <br /> 1 <br /> r <br />
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