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Get Da Form 5381

U.S. DOD Form dod-da-5383-r HOT-WORK PERMIT For use of this form see AR 420-90 the proponent agency is ACSIM 1. Are heat producing devices safe if left at work site 23. b. DATE 24. REMARKS NOTE PERMIT VALID ON DAY OF OPERATION AT ONE LOCATION ONLY DA FORM 5383-R SEP 92 EDITION OF JAN 85 IS OBSOLETE USAPPC V1. LOCATION 2. DATE 3. PERMIT NO. 4. TYPE OF WORK 5. START TIME 6. FINISH TIME 7. a* NAME OF PERSON RESPONSIBLE FOR HOT-WORK AT JOB SITE Contractor/Government Employee 7. b. SIGNATURE PRECAUTIONS BEFORE OPERATIONS CHECK ONE CHECKLIST YES NO 8. Did Fire Department Inspector inspect site 9. Are there procedures for Fire Department emergency notification Emergency No* 10. Are combustibles in area noted 11. Should combustibles be covered If yes note in remarks 12. Are proper extinguishers on hand 13. Is wet-down necessary If yes note in remarks 14. Is smoking permissible at work sites 15. Is continuous fire watch required 16. Is Fire Department standby required 17. Are other precautions required If yes note in remarks 18. a* FIRE DEPARTMENT INSPECTOR S SIGNATURE 18. b. DATE PRECAUTIONS AFTER OPERATIONS 19. a* Was Fire Department notified after hot-work operation was completed 19. b. Time 20. a* Did Fire Department inspector inspect work site 20. b. Time 21. Are after work conditions safe If no note in remarks 22. LOCATION 2. DATE 3. PERMIT NO. 4. TYPE OF WORK 5. START TIME 6. FINISH TIME 7. a* NAME OF PERSON RESPONSIBLE FOR HOT-WORK AT JOB SITE Contractor/Government Employee 7. b. SIGNATURE PRECAUTIONS BEFORE OPERATIONS CHECK ONE CHECKLIST YES NO 8. Did Fire Department Inspector inspect site 9. b. SIGNATURE PRECAUTIONS BEFORE OPERATIONS CHECK ONE CHECKLIST YES NO 8. Did Fire Department Inspector inspect site 9. Are there procedures for Fire Department emergency notification Emergency No* 10. Are combustibles in area noted 11. Are there procedures for Fire Department emergency notification Emergency No* 10. Are combustibles in area noted 11. Should combustibles be covered If yes note in remarks 12. Are proper extinguishers on hand 13. Is wet-down necessary If yes note in remarks 14. Should combustibles be covered If yes note in remarks 12. Are proper extinguishers on hand 13. Is wet-down necessary If yes note in remarks 14. Is smoking permissible at work sites 15. Is continuous fire watch required 16. Is Fire Department standby required 17. Is smoking permissible at work sites 15. Is continuous fire watch required 16. Is Fire Department standby required 17. Are other precautions required If yes note in remarks 18. a* FIRE DEPARTMENT INSPECTOR S SIGNATURE 18. Are other precautions required If yes note in remarks 18. a* FIRE DEPARTMENT INSPECTOR S SIGNATURE 18. b. DATE PRECAUTIONS AFTER OPERATIONS 19. a* Was Fire Department notified after hot-work operation was completed 19. b. DATE PRECAUTIONS AFTER OPERATIONS 19. a* Was Fire Department notified after hot-work operation was completed 19. b. Time 20. a* Did Fire Department inspector inspect work site 20. b. Time 21. Are after work conditions safe If no note in remarks 22.

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Keywords relevant to Da Form 5383

  • Combustibles
  • proponent
  • extinguishers
  • Sep
  • permissible
  • notification
  • checklist
  • DoD
  • OBSOLETE
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