Concrete Chipping/Coring Permit

Concrete Chipping / Coring Permit

Hālawa View Apartments
Seek an alternative/safer method if possible!

This permit is required for any chipping/cutting/coring that is required into the concrete slab, ceiling, or wall.
Date:*

YearMonthDay
Date
Start Time:*

Hour Minutes

AM/PM Option
End Time:*

Hour Minutes

AM/PM Option
Company:*
Location:*
Work to be done:*
THIS PERMIT IS GOOD FOR 24 HOURS
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Comments:
Name of Competent Person Requesting Chipping/Coring Permit:*
Signature of Competent Person:*
Stop! Get NPCL Supervisor authorization before submitting.

(Literally walk to an NPCL project team representative right now and have them sign before you press submit and before you start chipping.)
Name of NPCL Supervisor Authorizing Permit:*
Signature of NPCL Supervisor:*
I verify that the above location has been examined, the precautions marked on the checklist above have been taken, and permission is granted for this work.

I understand that I am to notify Nordic PCL if the chipping being done conflicts with any reinforcing or conduit. If the chipping being completed does any damage to the building's structure, the responsible parties will be held accountable for the costs of making the necessary repairs.
Should be Empty:

Concrete Chipping / Coring Permit