Will the fire alarm and/or detection system be inoperable or impaired? ( If yes Fill out interim Life Safety Measures )
Will emergency exits be obstructed? ( If yes fill out Interim Life Safety Measures )
Will repairs or maintenance be over occupied work areas? ( if yes fill out Interim Life Safety Measures )
Will normal traffic need to be rerouted? ( If yes fill out Interim Life Safety Measures )
Will their be work above the ceiling? ( If yes fill out Facilities Management Work Permit )
Will air quality be affected temperature,moisture,dust,required air changes? (If yes give description of what will be done to maintain air quality )
Will work area need to be concealed due to dust or infection control? ( If yes give description of how area will be concealed )
Will noise levels be affected in the area? ( If yes give description of what will be done to minimize noise levels )
Is personal protective equipment available in work area?
Has everyone around the work area been notified of work to be performed?
Will their be any Hot Work? ( If yes have Facilities Management fill out hot work permit )
Is fire extinguisher available in work area?