Title Page
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Client / Site
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Conducted on
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Prepared by
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Location
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Review the following questions to determine if the space is one of the following:
- Not a Confined Space
- Confined Space
- Permit Required Confined Space -
1) Was the area designed for products and/or Process, but NOT for people to occupy during regular operations?<br>2) Is the entry portal / doorway / hatchway restricted and/or difficult to get into or exit from (Vertical or Very small)?<br>3) Is the area large enough to enter, and must the employees bodily enter the area to get the work accomplished?<br>If you answer NO to any of these questions, select NO.<br>
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The space is not considered a Confined Space. Evaluate the space for hazards and take additional precautions as necessary.
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The space is considered a Confined Space, review the next question to determine if a Permit is required.
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1) Air Quality: Is there a potential for dangerous atmospheric condition in the space? (Low Oxygen – High Oxygen – Flammable Vapors – Carbon Monoxide – Toxic Gasses)<br>2) Engulfment: Is there a possibility of product entering the space? (Liquids – Solids – Grains – Dirt – etc.)<br>3) Room Configuration: Dangerous fall hazards, Equipment entrapment potential, Steep / Slippery flooring, Etc.<br>4) Other Hazardous Conditions: Welding, Hot Work, Chemicals, Dust, Noisy operations, Etc.<br>If you answer NO to any of these questions, select NO.
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The space is NOT a permit required confined space. Non-permit required confined spaces do not contain additional hazards such as the potential of a hazardous atmosphere or the potential for workers to become engulfed or trapped by materials. These spaces require a comprehensive safety plan and employers should then follow the requirements in OSHA standard 1910.146.
Non-permit required confined spaces can be continually accessed by workers, but are still associated with inherent difficulties stemming from the tight spaces. Signage is not required by OSHA, but workers should still exercise a great deal of caution. -
The space is considered a permit required confined space.
A Permit Required Confined Space Must have an attendant (hole watch) present at all times during the entry. Rescue plans, equipment, and trained personnel must be in place prior to entry.
