Audit

Confined Space ID # (If already classified as a confined space):

Location of Space(s):

Add location

Process/Item Name:

Take a picture of the space:

Squadron:

Office Symbol

Commander/FM's Name and Grade:

DSN:

1. Is the space large enough for an employee's whole body to enter?

2. Are there limited/restricted openings making entry/egress difficult?

3. Is the space designed for continuous human occupancy?

4. Identify all that apply to the space:

List recognized/known hazards:

5. Is it possible to eliminate all the hazards without anyone entering the space?

How/Why?

6. How frequently will the space be entered?

How Often?

7. Location(s) and description of the space to be entered (If not specific enough above):

8. Purpose of entry into the space

9. Tasks or operations to be performed in the space: (attach separate list if more space is needed)

Commander/FM Justification (Optional):

Commander/FM Signature
Date of Assessment
Tenant/OSM Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.