Fatal Risk - Confined Space

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Is a contractor being audited?

  YES

  NO

• Which contractor company?

• Foundational aspects applicable to all Fatal Risks that address: housekeeping, workplace exams, FLRA, training confirmation, and emergency protocols.

• Is the work area housekeeping in good order? (i.e., clear walkways and organized tools/materials)

  YES

  NO

• Has a workplace exam been conducted?

  YES

  NO

• Have all hazards been identified, corrected, or communicated?

  YES

  NO

• Has the employee conducted a Field Level Risk Assessment (FLRA) or Team Risk Assessment (TRA)?

  YES

  NO

• Has the employee received training? (i.e., task training, procedure or guidelines)

  YES

  NO

• Can the employee explain the proper emergency shut down, summoning for help and evacuation procedures? 

  YES

  NO

• Critical Controls: Actions and conditions that must be in place and functioning 100% of the time, without fail, to protect people when working in potentially significant risk situations.
  
  Instructions: For each critical control, select Controlled, AtRisk, or NA (Not Applicable or not observed). See Assessment below for definitions. If something is marked AtRisk, immediately Pause the work until the missing protections are put in place. Write the corrective action taken in the notes box below

Competency

• Has the worker been trained and authorized, and does the worker understand the components of confined space activity?

  Controlled

  At Risk

  N/A

Confine Space Permit

• Has the Confined Space Permit been completed and implemented correctly?

  Controlled

  At Risk

  N/A

• Is the attendant/spotter present while confined space is occupied?

  Controlled

  At Risk

  N/A

• Is the confined space attendant/spotter maintaining a register of people entering and exiting?

  Controlled

  At Risk

  N/A

• Are all confined space entry and exit locations guarded or barricaded and labeled to prevent unauthorized entry?

  Controlled

  At Risk

  N/A

• Is there effective communication between the confined space spotter/attendant and entrants?

  Controlled

  At Risk

  N/A

• Has a risk assessment been conducted and have proper controls been established for each risk identified?

  Controlled

  At Risk

  N/A

Atmospheric Testing and Monitoring

• Has the appropriate gas monitor been selected, pre-use bump tested conducted and valid calibration for use based on the identified hazards?

  Controlled

  At Risk

  N/A

• Is the atmosphere being tested, results documented per confined space permit, and appropriate controls implemented as per plan?

  Controlled

  At Risk

  N/A

Energy Isolation

• Have all sources of energy been identified, isolated by each occupant's personal lock, tagged, tried out, and in a zero-energy state?

  Controlled

  At Risk

  N/A

Emergency Response

• Do attendant and entrants have means to summon help and ability to self-rescue?

  Controlled

  At Risk

  N/A

• Are there at least two employees (no one working alone) while in the confined space?

  Controlled

  At Risk

  N/A

• Is the rescue plan and all required gear in place?

  Controlled

  At Risk

  N/A

• Do the attendees and entrants understand events that could trigger an evacuation or rescue and know how to initiate emergency response?

  Controlled

  At Risk

  N/A

• CONTROLLED The presence of this control is verified and effective

• ATRISK This control is missing or ineffective

• NA / NO Not Applicable to this exposure situation or Not Observed