Title Page

  • Conducted on

  • Prepared by

  • Location
  • QUESTION - What is the alarm limit for Carbon Monoxide?

  • QUESTION - Is H2S (or any other gas, pick one) heavier than air? (Note to evaluator: you can use any typical gas in this question)

  • QUESTION - Has your air tester been bump tested today? How do you know?<br>(answer should contain wording around it is done daily or there were no warnings, or mt charge hand confirmed that they are bt)

  • QUESTION - At what level of oxygen is dangerous?

  • QUESTION - When would you call safety?

  • QUESTION - When do you enter a confined space?<br>(only answer is NEVER)

  • QUESTION - How often do are you checking this hole?<br>(must be as per hazard assessment or permit)

  • QUESTION - What is the hazard level of the hole you are at?

  • QUESTION - If someone passes out in the hole what do you do?<br>(make sure the procedure correctly matches)

  • OBSERVATION - Is the ventilation set up correctly?

  • QUESTION - What do you do if someone gets hurt in a confined space?

  • OBSERVATION - Demonstrate how to zero the tester.

  • DOCUMENTATION - Are workers signing the hole watch sheet?

  • OBSERVATION - How long do you test this space (current space) for? (Calculate the depth of the space - two seconds per foot plus to minutes)

  • QUESTION - What task is listed on the permit?

  • QUESTION - What do you do if you suck water or other fluid into the hose?

  • QUESTION - How many holes can you watch at one time?

  • QUESTION - How often do you check a moderate confined space?

  • DOCUMENTATION - Are the headers on the hole watch sheet complete?

  • DOCUMENTATION - Has the permit been signed by the hole watch?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.