CSPT Installation Confined Spaces Program Annual Review

• This serves to document the annual review of the installation confined spaces program as required by DAFMAN 91-203 including annual reviews of the installation written confined space program, confined spaces map and/or inventory, and training programs.j

• Occupational Safety, Bioenvironmental Engineering, & Fire Emergency Services representatives will review and answer the following questions. If a discrepancy or follow-on actions need to be taken, it will be documented by creating an Action against that question and followed up every 30 days.

• Conducted on

  Date

Confined Spaces Program Annual Review by CSPT

• Has the OSM identified a safety representative to the CSPT? Reference 23.4.2.2

  Yes

  No

  N/A

• Has the installation Fire Chief identified in writing to the OSM, the appointed Fire Emergency Services representative to the CSPT, and certified the representative(s) is/are competent in confined space program requirements? Reference 23.4.4.

  Yes

  No

  N/A

• Has the installation Bioenvironmental Engineer identified in writing to the OSM, the appointed representative to the CSPT, and certified the representative(s) is/are competent in confined space program requirements? Reference 23.4.5.

  Yes

  No

  N/A

• Have Commanders and/or functional managers identified in writing to the OSM, their designated representative(s) to the CSPT and certify the representative(s) is/are competent in confined space program requirements and trained according to DAFMAN 91-203, para. 23.10?

  Yes

  No

  N/A

Confined Spaces Map/Inventory Annual Review

• Does the appointed safety representative to the CSPT maintain consolidated confined space inventories provided by each organization for all confined spaces, whether located on or off the installation, eg., geographically separated units.? Reference 23.4.2.2.2

  Yes

  No

  N/A

• Does the installation confined spaces map accurately reflect the consolidated confined space inventory?

  Yes

  No

  N/A

• Are any additions or removals of confined spaces accurately reflected on the consolidated confined space inventory and installation confined spaces map?

  Yes

  No

  N/A

• Upload the most current version of the consolidated confined space inventory & installation confined spaces map.

  Media

• Does the CSPT meet annually to conduct a review of the installation Confined Space Program? Reference 23.4.12.8

  Yes

  No

  N/A

• Does at least one representative from the installation Occupational Safety, BE and F&ES Flight representatives receive additional on-the-job training through each career field’s applicable training program? Reference 23.10.1.2

  Yes

  No

  N/A

• Are personnel required to test the atmospheric conditions in a confined space trained using manufacturer’s instructions or other information to develop effective training? Reference 23.10.2.1

  Yes

  No

  N/A

Master Entry Plans

• Are Master Entry Plans compliant with all OSHA, DAF, MAJCOM, and installation guidance/instructions?

  Yes

  No

  N/A

• Upload current year MEP.

  Media

Expired Entry Permits

• Do entry supervisors ensure DAF workers enter a permit-required confined space only after an AF Form 1024, Confined Spaces Entry Permit, or other entry permit, approved by the CSPT that meets the minimum documentation requirements, has been completed? Reference 23.4.8.7

  Yes

  No

  N/A

• During the past year, were expired entry permits filled out correctly and conducted IAW applicable instructions?

  Yes

  No

  N/A

• Upload the past year's expired entry permits.

  Media

Annual Review of Written Confined Space Program

• Has the commander ensured a written confined space program, developed and approved by the CSPT, is implemented IAW 29 CFR § 1910.136 and DAFMAN 91-203 Chapter 23? Reference 23.4.6.4.

  Yes

  No

  N/A

• Does this instruction incorporate the most current OSHA standards, DAF, and/or MAJCOM changes?

  Yes

  No

  N/A

• Are procedures established to review all construction projects to identify evaluate and classify new confined spaces, or changes to confined spaces? Reference 23.4.12.9.

  Yes

  No

  N/A

• Does this instruction fit the current needs of the installation confined spaces program?

  Yes

  No

  N/A

• Has the most current version of this instruction been distributed to all units with confined spaces?

  Yes

  No

  N/A

• Upload the most current installation written confined space program here.

  Media

Unit Training Programs

• Unit

  139FES

  139MXG

  Other

• Are entry supervisors & rescue team members trained and current in cardiopulmonary resuscitation (CPR)? Reference 23.4.8.6.

  Yes

  No

  N/A

• Are rescue procedures for each permit-required confined spaced covered under the Master Entry Plan? Reference 23.7.2.13.

  Yes

  No

  N/A

• Has the organization developed a structured and effective training program, to include a hands-on portion that establishes safe work practices and techniques? Reference 23.10.1.

  Yes

  No

  N/A

• Are personnel required to test the atmospheric conditions in a confined space trained using manufacturer's instructions or other information to develop effective training? Reference 23.10.2.1.

  Yes

  No

  N/A

• Is a list of personnel trained and knowledgable to conduct atmospheric testing and monitoring of confined spaces for their shop by name, name of trainer, and date completed training provided to the commander's designated representative? Reference 23.10.2.2.2.

  Yes

  No

  N/A

• Does rescue training cover rescue methods that the organization will use, e.g., self-rescue, non-entry rescue, entry rescue? Reference 23.10.3.

  Yes

  No

  N/A

Confined Spaces Program Team Coordination

• The below signed agree that all questions were answered truthfully & concur with the findings of this inspection.

• Occupational Safety

  Sign

• Bioenvironmental Engineering

  Sign

• Fire Emergency Services

  Sign