Title Page
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Conducted on
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Prepared by
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Location
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QUESTION - What is the alarm limit for Carbon Monoxide?
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QUESTION - Is H2S (or any other gas, pick one) heavier than air? (Note to evaluator: you can use any typical gas in this question)
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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)
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QUESTION - At what level of oxygen is dangerous?
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QUESTION - When would you call safety?
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QUESTION - When do you enter a confined space?<br>(only answer is NEVER)
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QUESTION - How often do are you checking this hole?<br>(must be as per hazard assessment or permit)
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QUESTION - What is the hazard level of the hole you are at?
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QUESTION - If someone passes out in the hole what do you do?<br>(make sure the procedure correctly matches)
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OBSERVATION - Is the ventilation set up correctly?
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QUESTION - What do you do if someone gets hurt in a confined space?
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OBSERVATION - Demonstrate how to zero the tester.
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DOCUMENTATION - Are workers signing the hole watch sheet?
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OBSERVATION - How long do you test this space (current space) for? (Calculate the depth of the space - two seconds per foot plus to minutes)
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QUESTION - What task is listed on the permit?
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QUESTION - What do you do if you suck water or other fluid into the hose?
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QUESTION - How many holes can you watch at one time?
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QUESTION - How often do you check a moderate confined space?
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DOCUMENTATION - Are the headers on the hole watch sheet complete?
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DOCUMENTATION - Has the permit been signed by the hole watch?