INFO
Reference
Notes
Contractor (Company Name):
Notes
Description of Work & Area of Work:
Notes
TOTAL FIRE BANS DAYS
Total Fire Day Ban days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Notes
If yes, attach local fire authority permit
Yes
N/A
Notes
PRECAUTIONS
If yes, local fire authority permit must be obtained.
PRECAUTIONS: (Place Y yes, N no or N/A not applicable in each box if no listed other / additional precautions section must be completed)
Unanswered
Area clear of combustible material.
Yes
No
N/A
Notes
Combustible floors and walls shielded from flame/sparks.
Yes
No
N/A
Notes
Fire extinguisher located in work area.
Yes
No
N/A
Notes
Flashback arresters fitted to all oxy equipment.
Yes
No
N/A
Notes
Personal protective equipment, e.g. eyewear, gloves, welding screens.
Yes
No
N/A
Notes
Welding screens available
Yes
No
N/A
Notes
Oxy and acetylene bottles adequately secured in cradle and remain upright.
Yes
No
N/A
Notes
List other / additional precautions:
Notes