CONFINED SPACE INITIAL DETERMINATION CSID

• Audit Title

• Document No.

• Client Name

• Client Address
  Address

• Conducted on

  Date

• Prepared by

• Specific Location of Vessels/Confined Space.
  Address

CONFINED SPACE INITIAL DETERMINATION

Confined Space Requirements

• As per Part 9 of WSBC Regulation Section 9.2 Initial Determination The Employer must (a) ensure that each confined space in the workplace is identified, and (b) determine whether any such space will require entry by worker, either in scheduled work activities or as a result of foreseeable system failures or other emergencies.

• As per Part 9 of WSBC Regulation definition: (a) is enclosed or partially enclosed.

  YES

  NO

• As per Part 9 of WSBC Regulation definition : (b) is not designed or intended for continuous human occupancy.

  YES

  NO

• As per Part 9 of WSBC Regulation definition : (c) has limited or restricted means for entry or exit that may complicate the provision of first aid, evacuation, rescue, or other emergency response service.

  YES

  NO

• As per Part 9 of WSBC Regulation definition : (d) is large enough and so configured that a worker could enter to perform assigned work.

  YES

  NO

• Are the Vessels/Confined Space decommissioned?

  YES

  NO

Name, Number, Size, Location or Volume

• Upright square/Rectangle Vessel/Confined Space Open Top/Removable Top

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note section.

  YES

  NO

• Upright Oval/Round Vessel/Confined Space Open Top/Removable Top

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note section.

  YES

  NO

• Horizontal square/Rectangle Vessel/Confined Space Open Top/Removable Top

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Horizontal Oval/Round Vessel/Confined Space Open Top/Removable Top

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Upright Square/Rectangle Vessel/Confined Space Manhole Access/Egress

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Upright Oval/Round Vessel/Confined Space Manhole Access/Egress

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Horizontal Square/Rectangle Vessel/Confined Space Manhole Access/Egress

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Horizontal Oval/Round Vessel/Confined Space Manhole Access/Egress

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Electrical Vault/Electrical Room Exterior/Interior

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is Electrical Vault/Electrical Room a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Piping large enough to fit a Human/24 inches/60cm or bigger.

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is the Piping system Vault a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is there a Top Port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Middle port or access/egress? Enter dimensions in note section.

  YES

  NO

• Is there a Bottom port or access/egress? Enter dimensions in note area.

  YES

  NO

• Weigh Scale

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Is there a port or access/egress? Enter dimensions in note area.

  Yes

  No

  N/A

• Foundry Heat Treat Furnace

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is there a port or access/egress? Enter dimensions in note area.

  YES

  NO

• Fruit Presser

  Select 1 access/egress 2 access/egress 3 access/egress >3 access/egress At Grade Below Grade Elevated

  • 1 access/egress
  • 2 access/egress
  • 3 access/egress
  • >3 access/egress
  • At Grade
  • Below Grade
  • Elevated

• Is Vessel/Confined Space a Simple or Complex Configuration?

  Select Simple Configuration Complex Configuration

  • Simple Configuration
  • Complex Configuration

• If Complex Configuration. Indicate type.

  Select Single Partition Multiple Partition T Shape L shape LShape Left Turn L Shape Right Turn L Shape Up L Shape Down Zip Zag Disjointed/Not Clear or Disorderly T Shape Up T Shape Down Y Shape Up Y Shape Down

  • Single Partition
  • Multiple Partition
  • T Shape
  • L shape
  • LShape Left Turn
  • L Shape Right Turn
  • L Shape Up
  • L Shape Down
  • Zip Zag
  • Disjointed/Not Clear or Disorderly
  • T Shape Up
  • T Shape Down
  • Y Shape Up
  • Y Shape Down

• Indicate access/egress configuration.

  Select Square Round Oval Verticle Oval Horizontal Rectangle Horizontal Rectangle Verticle

  • Square
  • Round
  • Oval Verticle
  • Oval Horizontal
  • Rectangle Horizontal
  • Rectangle Verticle

• Is there a port or access/egress? Enter dimensions in note area.

  Yes

  No

  N/A

If Determined to be a Confined Space

• Insert Pictures of Vessel/Confined Space.

  Media

• Will there be any worker entry required?

  YES

  NO

• How often will there be entry?

  Regularly

  Once a month

  Once a year

  Intermittent

  Rarely

• Has there been a hazard assessment done on this space(s)?

  YES

  NO

• Have hazard controls for this space been developed and implemented?

  YES

  NO

• Is there a Confined Space Program in place?

  YES

  NO

• Has an entry procedure been developed for this space?

  YES

  NO

  Not Applicable

  NON-ENTRY

• Is there a developed confined space entry and rescue plan in place?

  YES

  NO

  Not Applicable

  NON-ENTRY

• Is there Gas Testing process and documentation in place?

  YES

  NO

  Not Applicable

  NON-ENTRY

• Are there any energy sources to be locked out?

  YES

  NO

• Is there a Lockout/Tagout Program/Procedures in place?

  YES

  NO

If NOT Determined to be a Confined Space (Restricted Space)

• Insert pictures of Vessel/Confined Space.

  Media

• Will there be any worker entry required?

  YES

  NO

• How often will there be entry?

  Regularly

  Once a month

  Once a year

  Intermittent

  Rarely

• Has there been a hazard assessment done on this space(s)?

  YES

  NO

• Have hazard controls for this space been developed and implemented?

  YES

  NO

• Has an entry procedure been developed for this space?

  YES

  NO

  Not Applicable

  NON-ENTRY

• If there is worker entry,has a Rescue Plan been developed?

  YES

  NO

  Not Applicable

  NON-ENTRY

• Is there Gas Testing process and documentation in place?

  YES

  NO

  Not Applicable

  NON-ENTRY

• Are there any energy sources to be locked out?

  YES

  NO

• Is there a Lockout/Tagout Program/Procedures in place?

  YES

  NO

Exclusion Criteria from BC Web Regulation Guidelines Part 9

• Enclosed spaces that are not "Confined Spaces" for the purposes of the application of Part 9 must satisfy specific exclusion criteria. To determine that a space is not a Confined space, it must be identified as a space described below and must meet all the criteria.

• Spaces that may be excluded from Part 9, provided that all the exclusion Criteria are met. Spaces are; Swimming Pools, Excavations, Attic Spaces, Open,unconnected wet wells or dry wells for storm or sewer hookups at new construction sites, elevator shafts, HVAC Plenums.

• The desing,construction, Location and intended use of these spaces will ensure these spaces are characterized by clean respirable air. The space must have an interior Volume of not less than 64 cubic feet per occupant. There must be not potential for high or moderate atmosphere, as defined in section 9.2 of the Regulation, to exist or develop immediately prior to any worker entering the space or during any work with the space. There must not be a need to mechanically ventilate, clean, purge, or inert the space prior to entry for any reason. There must be no potential for a hazard us substance to migrate through any media (e.g. air, soil, conveyance, piping or structure) to infiltrate the space. The space must be free of residual material (e.g. waste, sludge, debris) that if disturbed could generate Air contaminants that could imediatleyand acutely affect a worker's health, There must not be any risk of entrapment or engulf mentioned to workers entering the space. The space must not contain, have introduces, or be adjacent to tools, equipment, or involve processes that could generate air contaminants that could immediately and acutely affect a worker's health.

• Where all exclusion Criteria are met, an employer through consultation with a worker, worker health and safety representitive, or joint committee may make a determination that the space is not a Confined space for the purposes of Part 9 of the Regulation, and document that decision.

DETERMINATION REGARDING OTHER SPACES

• Work safe may determine other types of spaces to be excluded from the application of Part 9 of the Regulation which do not meet the exclusion Criteria or include spaces where an employer proposes to perform work that will generate air contaminents.Such determinations will be made based on an evaluation by a committee of Work safe BC Personnel with expertise in confined spaces. Persons interested in having WSBC assess whether a certain type of space should be determined not to be a Confined Space for the purposes of Part 9 of the Regulation may contact the Regulatory Practiciesa Department or the WSBC office in their Region.

• Assessor Signature

  Sign

• Site Representative Signature

  Sign