Confined Spaces Checklist.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

23.11. Confined Spaces Checklist.

• 23.11.1. Has the commander and/or functional manager developed and implemented a written<br>confined space program? Reference 23.2.7

  Yes

  No

  N/A

• 23.11.2. Does the commander and/or functional manager ensure personnel who support the permitrequired<br>confined space program are properly trained, equipped and qualified? Reference23.2.7.2)

  Yes

  No

  N/A

• 23.11.3. Does the commander and/or functional manager ensure required equipment is available and<br>properly maintained? Reference 23.2.7.3

  Yes

  No

  N/A

• 23.11.4. Does the commander and/or functional manager maintain a current list of all confined<br>spaces, both permit-required and non-permit, under the control of their organization? Reference<br>23.2.7.4

  Yes

  No

  N/A

• 23.11.5. Does the entry supervisor have a copy of the MEP? Reference 23.2.8.1

  Yes

  No

  N/A

• 23.11.6. Prior to the start of entry operations, does the entry supervisor ensure workers are properly<br>trained and qualified in safe operating, emergency and egress procedures, and the use of PPE?<br>Reference 23.2.8.5

  Yes

  No

  N/A

• 23.11.7. Prior to allowing entry to the confined space, does the entry supervisor brief workers on the<br>hazards of the operation? Reference 23.2.8.6

  Yes

  No

  N/A

• 23.11.8. Does the confined space attendant maintain an accurate account of all entrants by name and<br>time in and out of the permit-required space? Reference 23.2.9.1

  Yes

  No

  N/A

• 23.11.9. Does the attendant maintain continuous communication with all authorized entrants within<br>the permit-required space via the most viable means of communication? Reference 23.2.9.3

  Yes

  No

  N/A

• 23.11.10. Does the attendant ensure unauthorized persons are not allowed in the permit-required<br>space? Reference 23.2.9.7

  Yes

  No

  N/A

• 23.11.11. As appropriate, does the confined space entrant notify the entry supervisor when hazards<br>existed that had not been previously identified? Reference 23.2.10.3

  Yes

  No

  N/A

• 23.11.12. Does the commander or functional manager identify all confined spaces within their<br>organization, located both on and off the installation? Reference 23.3.2

  Yes

  No

  N/A

• 23.11.13. Do functional managers and entry supervisors ensure the organization‘s confined spaces<br>are evaluated and tested prior to being classified? Reference 23.3.2

  Yes

  No

  N/A

• 23.11.14. Is initial testing of confined spaces accomplished by a technically qualified member of the<br>installation CSPT prior to the space being classified? Reference 23.3.3

  Yes

  No

  N/A

• 23.11.15. Are danger signs posted at permit-required confined spaces, as appropriate? Reference<br>23.3.5

  Yes

  No

  N/A

• 23.11.16. Does the entry supervisor establish a frequency for atmospheric monitoring and the type of<br>tests to monitor the tests, and ensures the requirements were entered on the MEP and entry permit?<br>Reference 23.3.9

  Yes

  No

  N/A

• 23.11.17. Does the entry supervisor ensure workers obtain an AF Form 1024, Confined Spaces<br>Entry Permit, prior to entering a permit-required confined space? Reference 23.5.1

  Yes

  No

  N/A

• 23.11.18. Are entry permits, including those canceled or revoked, retained on file for one year?<br>Reference 23.5.1.2

  Yes

  No

  N/A

• 23.11.19. Does the entry supervisor ensure entry into known IDLH spaces are only authorized after<br>the required conditions for IDLH are met? Reference 23.5.3

  Yes

  No

  N/A

• 23.11.20. Does the entry supervisor ensure workers entering IDLH spaces are equipped with proper<br>PPE, including a positive pressure SCBA and a harness of a type suitable to permit extraction of the<br>worker? Reference 23.5.3.4

  Yes

  No

  N/A

• 23.11.21. Does the entry supervisor ensure only explosion-proof or intrinsically safe equipment is<br>used when flammable or explosive atmospheres are present for IDLH operations? Reference<br>23.5.3.7

  Yes

  No

  N/A

• 23.11.22. Does the entry supervisor ensure a qualified FES Flight specialist is present during all<br>IDLH space operations? Reference 23.5.3.9

  Yes

  No

  N/A

• 23.11.23. When additional hazards are present or may be introduced in a permit-required operation,<br>does the entry supervisor ensure the hazards are adequately addressed on the entry permit?<br>Reference 23.5.4.4

  Yes

  No

  N/A

• 23.11.24. When toxic materials are present or may be introduced in a permit-required operation,<br>does the entry supervisor contact BE to determine the necessity for respiratory protection<br>equipment? Reference 23.5.4.4.1

  Yes

  No

  N/A

• 23.11.25. Does the organization have a MEP, as appropriate? Reference 23.5.4.10

  Yes

  No

  N/A

• 23.11.26. Are entry permits revoked whenever any testing in the space is not within established<br>parameters in the MEP? Reference 23.5.4.10.5

  Yes

  No

  N/A

• 23.11.27. Is an AF Form 592, USAF Welding, Cutting, and Brazing Permit, obtained by workers<br>prior to performing hot riveting, welding, cutting, burning or heating operations within a confined<br>space? Reference 23.5.5

  Yes

  No

  N/A

• 23.11.28. Does the commander or functional manager ensure non-permit required confined spaces<br>are reviewed periodically (but no less than annually)? Reference 23.5.6.2

  Yes

  No

  N/A

• 23.11.29. Does the MEP include emergency and rescue procedures consistent with the nature of each<br>operation that requires entry into a permit-required confined space? Reference 23.6.1

  Yes

  No

  N/A

• 23.11.30. Does the entry supervisor ensure an organization rescue team is available when the<br>installation FES Flight is unable to provide a team? Reference 23.6.1.3

  Yes

  No

  N/A

• 23.11.31. Does the entry supervisor ensure all members of the rescue team is trained and current in<br>CPR and basic first aid during permit-required confined space entry operations? Reference<br>23.6.1.3.2

  Yes

  No

  N/A

• 23.11.32. Does the entry supervisor ensure the inspection, testing, maintenance and documentation<br>of safety and rescue equipment are accomplished prior to an operation being performed? Reference<br>23.6.2

  Yes

  No

  N/A

• 23.11.33. Does the organization have an effective training program that incorporates safe work<br>practices and techniques? Reference 23.7.1

  Yes

  No

  N/A

• 23.11.34. Does the organization ensure each member assigned permit-required confined space duties<br>is trained prior to being assigned? Reference 23.7.1.3

  Yes

  No

  N/A

• 23.11.35. Does the organization ensure all individuals authorized and assigned permit-required<br>confined space entry duties complete site-specific training? Reference 23.7.2

  Yes

  No

  N/A

• 23.11.36. Do all rescue team members receive initial and annual hands-on training in removing<br>simulated victims from actual or representative confined spaces? Reference 23.7.3.1

  Yes

  No

  N/A

• 23.11.37. Does the installation CSPT periodically review and assess the rescue team training?<br>Reference 23.7.5

  Yes

  No

  N/A

• 23.11.38. Is confined space training documented on an AF IMT 55, Employee Safety and Health<br>Record, or an authorized computerized information management system? Reference 23.7.5

  Yes

  No

  N/A

• 23.11.39. Does the organization ensure all of the requirements are met prior to a contractor<br>performing work that involves a permit-required confined space entry? Reference 23.8.1

  Yes

  No

  N/A

• 23.11.40. Does the organization coordinate entry operations and procedures with the contractor prior<br>to both organizational and contractor personnel working in a permit-required confined space?<br>Reference 23.8.2)

  Yes

  No

  N/A