Catalyst Technologies Confined Space Entry Inspection - duplicate

• Conducted on

  Date
• Location
  Address

• CLIENT

• C. S. SUPERVISOR/FOREMAN

• HEALTH & SAFETY MANAGER

• JOB NUMBER

• CONFINED SPACE DESCRIPTION

• What class of entry?

  Class A

  Class B

  Class C

SITE PERSONNEL

• Project Manager onsite? PM's name.

  Yes

  No

  N/A

• PM'S Name listed on the entry permit?

  Yes

  No

  N/A

• Entry Supervisor (topside supervisor) on site? Record name.

  Yes

  No

  N/A

• Name listed on the entry permit?

  Yes

  No

  N/A

• Top side safety / standby listed on data sheet?

  Yes

  No

  N/A

• Completed helmet pre entry safety checks?

  Yes

  No

  N/A

• Results of go - no go test documented?

  Yes

  No

  N/A

• List the readings of the test.

• In vessel watchman required?

  Yes

  No

  N/A

• Completed helmet pre entry safety checks?

  Yes

  No

  N/A

• Results of go - no go test documented?

  Yes

  No

  N/A

• List the readings of the test.

• Entrant(s) Named on Data entry sheet?

  Yes

  No

  N/A

• Completed helmet pre entry safety checks?

  Yes

  No

  N/A

• Results of go - no go test documented?

  Yes

  No

  N/A

• List the readings of the test.

PERMIT

• All sections completed and initialed?

  Yes

  No

  N/A

• Is the customer permit listed on the data entry sheet?

  Yes

  No

  N/A

• Emergency contact section filled out?

  Yes

  No

  N/A

• Duration specified?

  Yes

  No

  N/A

• Atmosphere Monitoring results documented?

  Yes

  No

  N/A

• Entrant IN/OUT time completed?

  Yes

  No

  N/A

• Hourly in vessel checks documented?

  Yes

  No

  N/A

• Class of entry?

  Class A

  Class B

  Class C

POSTING

• All entrances posted?

  Yes

  No

  N/A

• Permit posted or equivalent?

  Yes

  No

  N/A

• Unattended entrance posted/secure?

  Yes

  No

  N/A

• Area barricaded to prevent unauthorized personnel from entering restricted area?

  Yes

  No

  N/A

ISOLATION

• Energy sources identified?

  Yes

  No

  N/A

• Energy sources isolated?

  Yes

  No

  N/A

• Isolation point recorded on the confined space isolation record? (Blind list of customers attached to the confined space isolation record is acceptable.)

  Yes

  No

  N/A

• All isolation systems in place?

  Yes

  No

  N/A

• Tag out systems secure?

  Yes

  No

  N/A

• All personnel know the system (purpose/use)?

  Yes

  No

  N/A

ENTRY CONDITIONS

• Acceptable conditions documented?

  Class A

  Class B

  Class C

• Air monitoring appropriate for the class of entry?

  Yes

  No

  N/A

• Initial monitoring from outside the space prior to entry?

  Yes

  No

  N/A

• Was the monitoring of the space performed to the SOP requirements?

  Yes

  No

  N/A

• Are the results communicated to the entry crew?

  Yes

  No

  N/A

AIR MONITORING

• Air monitoring equipment calibrated?

  Yes

  No

  N/A

• List the calibration date.

• Initial Oxygen level recorded?

  Yes

  No

  N/A

• LEL level recorded?

  Yes

  No

  N/A

• H2S levels recorded?

  Yes

  No

  N/A

• CO levels recorded?

  Yes

  No

  N/A

• Other hazard(s) monitored?

  Yes

  No

  N/A

• List additional monitoring.

PPE

• Entrant?

  Yes

  No

  N/A

• Appropriately used?

  YES

  NO

• Properly worn?

  YES

  NO

• Attendant?

  Yes

  No

  N/A

• Appropriately used?

  YES

  NO

• Properly worn?

  YES

  NO

• Others?

  Yes

  No

  N/A

• Appropriately used?

  YES

  NO

• Properly worn?

  YES

  NO

• Attendant prepared?

  Yes

  No

  N/A

COMMUNICATION

• Voice?

• Electronic?

• Visual?

• Signal System?

• Other?

• Describe type.

• Documented / Verified Initially?

  Yes

  No

  N/A

• Documented / Verified Periodically?

  Yes

  No

  N/A

ENTRY EQUIPMENT

• LIGHTING

• Natural

• Can all entrants actions be seen?

  Yes

  No

  N/A

• Artificial

• Can all entrants actions be seen?

  Yes

  No

  N/A

• Class & Division appropriate?

  Yes

  No

  N/A

• Ladders

• Select type of ladder

  stiff,sectional

  cable

  other

• Are the proper pins used to secure ladders?

  Yes

  No

  N/A

• What is the condition of the ladder

  Excelent

  Good

  Poor

  Unusable

• Has the ladder been inspected for damage before use?

  Yes

  No

  N/A

• What is the condition of the ladder

  Excelent

  Good

  Poor

  Unusable

• What the of ladder is being used?

• What is the condition of the ladder

  Excelent

  Good

  Poor

  Unusable

• Exclusion zone has Barriers / guards in use?

  Yes

  No

  N/A

• Additional equipment needs.

• Type of retrieval device in use?

  Tripod

  A frame

  Other

• Has the tripod been inspected prior to use.

  Yes

  No

  N/A

• Is the tripod set up properly?

  Yes

  No

  N/A

• Has the A frame been inspected prior to use?

  Yes

  No

  N/A

• Is the A frame set up properly?

  Yes

  No

  N/A

• Is this retrieval device appropriate to the task?

  Yes

  No

  N/A

• Has it been approved by the H&S and Management through the variance process?

  Yes

  No

  N/A

• Stokes Basket or equivalent at entry point?

  Yes

  No

  N/A

• Oxygen resuscitation bottles available at entry point?

  Yes

  No

  N/A

• AED available at point of entry?

  Yes

  No

  N/A

• Is high angel rescue required?

  Yes

  No

  N/A

• High angel rescue kit staged appropriately?

  Yes

  No

  N/A

• Emergency Egress Line set up close to entry point?

  Yes

  No

  N/A

• Is there a line for each Entrant and Stand by Watchman?

  Yes

  No

  N/A

• Is the EEL within reach of each Entrant?

  Yes

  No

  N/A

VENTILATION

• Supply

• What class of entry?

  Class A

  Class B

  Class C

• Is the nitrogen supply locked in the open position?

  Yes

  No

  N/A

• Exhaust

• General Exhaust

• Local Exhaust

• Appropriate for hazard?

  Yes

  No

  N/A

• Sufficient Quantity? (Size of space-blower capacity)

  Yes

  No

  N/A

• Clean make-up air?

  Yes

  No

  N/A

• Blower Secure?

  Yes

  No

  N/A

• Bonding ok?

  Yes

  No

  N/A

• Grounding?

  Yes

  No

  N/A

• Checked for continuity?

  Yes

  No

  N/A

EMERGENCY PLANNING/RESPONSE

• Rescue plan available?

  Yes

  No

  N/A

• Emergency notification means set up?

  Yes

  No

  N/A

• Telephone

• 2-way

• Cellular

• Other

• Describe.

GENERAL SITE CONDITIONS OR COMMENTS

• Brief description of site.

• Brief description of crew.

• Site Conditions?

  Excellent

  Good

  N.I.

  Poor

  Unsatisfactory

• Attach picture of the site if applicable.

  Media

• REVIEWED H&S MANAGER:

  Sign

• SUPERVISOR / FOREMAN

  Sign