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    Isolation Form Elg2

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    jherson gravides

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    Isolation Form Elg2

    Uploaded by

    jherson gravides
    7 views2 pages

    Original Title

    ISOLATION FORM ELG2

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    © © All Rights Reserved

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    © All Rights Reserved
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    7 views2 pages

    Isolation Form Elg2

    Uploaded by

    jherson gravides

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 2
    3. Authorization (iniemal Use): Name of person Permit Number 4, Person requesting the isolation (Building-FIPP- ELG2 - FIPP- 0322 = a Sci Nsctiia ean Se MMSE: 2 Tenart Name of person requesting CHARLES REYES eae, eee Ig) Gi Comtractor (ame) Dateof submission Jusly 22, 2022 Signature Mobile Prone ‘ Uicaleneee 2. Isolation request details: complete and forward to Property Building ELG?d Level/s 12 Rooms UMiT~ 1 5 Reason for isolation ald Construction Isolation occurring under the eee Less than 12 hours only, Isolate atthe building vedi Ne dare Yes ONo" op ing business hours 6am- (orareentovets on) 1800, less than 20% of building isolated : s (ie daily) Requirements (areas | Isolate from security office vege pj Isolate for more than *2 hours marked wit’ wilrequte — irmeve than corn. cr overige Yes "1 No iene builsing) (ie: continuous) Sete July 22, 2022 July 22, 2022 eee pa 5200 pM Indicate days Mon. OTues, GWec, OThus, Fn. OSat Sun. * For isolation: Treasury Managed Fund must be notified under the following conditions >20% building Isolated, after hours, more than one day through the Treasury Management Fund — fire impaiment notification process. Use link to the notification ENGR. JHERSON GRAVIDES form authorizing the isolation Certficate number & expiry Signature Date ot authorization ee Phone number 09054672 gue 4. Implementation Name of person isolating RDEL = MAVALAN.SAN Phone Numper Pane Date of isolation July 22,2022 Signature Time isolates N00 py Name of person ROEL MANALansan Uusetiaisl al deisolating the FIP Mee kes kas Signature Tine cede S00 PH 4. Person requesting the isolation Name of person requesting the isolation pes ELGL —_ Levels a Reason for isolation Hasictedaoed) Constuction SMOKE DETETIR SOME wrt Permit Number (Building-FIPP- ELG2 - Fipp~ 0701 date) ot a D Tenant Di Business Entity CO Contractor (name) Dateotsubmission July of, 2002 Mobile Phone number OFS 4G12 Be ¥) 30, 35 Rooms Au Umie wee TO RERACE Isolation occurring under the folowing conditions Less than 12 hours only, Isolate atthe building Dyes @No* Yes. No , during business hours 6am- (erarestevesony) | “00 Tess nan 20% oF building isolated S (ie daily) Requirements (areas ao — etedwerwaroqure | patetromseartyotiee / y,4.c, | Rolwalormorethan *2houe insurance compary (fer morethan 20K offre or ovemi es *CNo notification ing) (i continuous) daly 01, row a/A 10:00AM Indicate days ZiMon, Tues. WWec. WThus. Fn Sat Sun 3, Authorization (Inieal Use): For isolation: Treasury Managed Fund must be notified Lncer the following conditions >20% building isolated, efter hours, more than one day through the Treasury Management Fund — fre impaiment notfication process, Use link to the notification Name of person se Use| authorizing the ENGR. HERI Spawn f isolation Certficate number & expiry eree Date of authorization Signature 2 Phone number OAuS4EI2 bre 4. Implementation: Name of person isolating LieBunta Phone Number ae Date of isolat on Lily 01, 2022 See Lime isolated come Name of person Phone Number

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