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ARCHIVED REPORTS_XR0006286
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545598
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ARCHIVED REPORTS_XR0006286
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Last modified
3/23/2020 4:12:19 PM
Creation date
3/23/2020 4:06:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006286
RECORD_ID
PR0545598
PE
3528
FACILITY_ID
FA0001304
FACILITY_NAME
STOCKTON SCAVENGERS ASSOCIATION
STREET_NUMBER
1240
STREET_NAME
NAVY
STREET_TYPE
DR
City
STOCKTON
Zip
95206
CURRENT_STATUS
02
SITE_LOCATION
1240 NAVY DR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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uriaTHE <br /> MARK Hot Work Permit <br /> GROUP <br /> ENGINEERS 6 GEOLOGISTS, INC <br /> • <br /> Contract Job Number <br /> Operating Area Good for this date Only 19 <br /> Specific vessel, equipment or construction <br /> Work to be done <br />' TESTS <br /> PERCENT OTHERS <br /> LOWER <br /> STATE EXPLOSION PERCENT <br /> LOCATION OF TEST TIME LIMIT OXYGEN INITIAL <br /> CHECK LIST Initial PERSONNEL <br /> Yes Not PROTECTIVE EQUIPMENT <br /> APPiy EYES <br />' ❑ Chemical Goggles <br /> Operations/plant personnel have been informed of work to be performed ❑ Face shield <br /> ❑ Safety Gasses <br /> All tanks/lines/valves are disconnected blinded or locked out ❑ welders Mask <br /> 10 Equipment and all attached piping has been cleaned and purged wrth BODY <br /> Envifo <br /> (check blank Water Steam Inert as Air ❑ Heavy Suit sun ❑ Pvc ❑&,M <br /> \ � 9 Q Heavy$ill[ ❑ PvC ❑Nopp«,. <br /> ❑ Ught PVC Sort <br /> Electrical service has been locked out and tagged p Yellow Tyveksul <br /> All grounding/bonding wires In place 0 White Tyvek sun <br /> EXrREMITI ES <br /> Surrounding equipment and operations are safe for hot work ❑ Hard Hat <br /> ❑ Gloves <br /> No open vessels or Imes within 35 feet of hot work area ❑ Boots ❑ PVC CI Neogene <br /> ❑ Hoods ❑ Pvc ❑ 1440F n. <br /> Combustible items within 35 feet of hot work have been removed or covered with wetted ❑ Fou coverings <br /> tarpaulins ❑ Dsposabie <br /> Fire Watch has been provided by Contractor RESPIRATORY <br />' 0 Self-Contamed Respirator <br /> No flammable gasses greater than 10%LEL in hot work area ❑ Hose Line Respirator <br /> ❑ Canrldge Respirator <br /> All requirements of for Confined Space Entry have been met and Canridge Type <br />' have been completed and posted ❑ Dust Respirator <br /> If vessel contains product all requirements of have EOUIPMENT REOUIRED <br /> been met ❑ Fire Extinguisher <br /> Q Fire Blanket <br />' ❑ Charged water Hose <br /> ❑ Combusilbie Gas Ind"Or <br />' Special Instructions <br /> 0 <br /> Completed By <br /> Name Prmted S-gnature Date <br /> 1 FIELD COPY(Wh rte) FILE COPY(Yellow) Prelacy Safety Otticm Review <br />
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