BURN PERMIT
CONDITIONS (ELECTRONIC): The same conditions apply as above, except this form can be submitted to the Electric Shop via the internet… To access this form on the internet go to the Engineering & Facilities home page and click on E & F Forms and select the Burn Permit form… Fill out the form and then click the submit button.
Bldg. Name: Bldg #: Room # or Area:
Work Order # or Project #(where time is to be charged):
Person-in-charge: Radio : Pager : Start Date : Start Time : Completion Date : Completion Time : Work to be done : Instructions before burning : Smoke detectors removed : Alarm system off : Alarm system out of service: YES NO Additional days granted: YES NO Approval (electric shop only): Date :
Safety check needed: YES NO Safety Officer's comments: Approval (Safety Officer Only): Date :