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2. Please provide the following contact information:
4. Hot Work Being Done By:
5. Location
7. Start Date*
   Start Date
8. End Date*
   End Date
10. Vessel Name*
12. Name & Title of Contact*
13. Company Name
14. Email Address*
16. Telephone Number*
18. Berth and/or Bay Number(s)
22. Required Precautions Checklist
24. 1. Name of Marine Chemist and copy of certificate (please have available if asked for).
25. 1. Care shall be taken as to the wind direction so that sparks do not ignite combustibles in the area of the hot work.
27. 1. Transferring of fuel is prohibited while hot work is being performed.
28. 1. Fire watch being manned (no other duties) with at least one UL approved fire extinguisher containing agent appropriate to existing conditions.
30. 1. Hot Work is not to be conducted within 30 feet of any combustible material.
31. 1. Hazardous Material on board
33. What / Where
35. 1. Qualified operator shall be in charge.
36. 1. All safety, local laws and ordinances shall be observed.
38. 1. Welding equipment located on the vessel.
39. 1. Port Engineer contacted for inspection of welding equipment dockside.
41. 1. User shall ensure at all times the welding leads are supported to prevent the leads from hanging into the water while welding takes place.
43. Hot Work performed without a permit will be subject to a $ 500 fine.
    Port Tariff Rule-GL, Item 477 and report filed with the U.S.C.G.
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46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

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