OSHA Confined Space Entry Procedure Checklist

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

Pre-operation

• Isolate the space from all hazards

  ✔

  ✖

  N/A

• Remove unauthorized personnel from the site of entry

  ✔

  ✖

  N/A

• Perform the LOTO procedure

  ✔

  ✖

  N/A

• Check for blocking inlets, etc

  ✔

  ✖

  N/A

• Ventilate the space (if required)

  ✔

  ✖

  N/A

• Fill out the Entry Permit

  ✔

  ✖

  N/A

• Evaluate the space

  ✔

  ✖

  N/A

• Test the atmosphere

  ✔

  ✖

  N/A

• Enter atmosphere readings on the permit

  ✔

  ✖

  N/A

• Place the completed permit on or near the PRCS

  ✔

  ✖

  N/A

Work In-Progress

• Enter the space and proceed with work

  ✔

  ✖

  N/A

• Check if the supervisor is available

  ✔

  ✖

  N/A

• Check if attendant at the entry site

  ✔

  ✖

  N/A

• Check if safety harness is utilized

  ✔

  ✖

  N/A

• Required PPE is being worn

  ✔

  ✖

  N/A

• Retest atmoshpere as needed / required

  ✔

  ✖

  N/A

Post operation

• Remove all personnel, tools, and debris from the space

  ✔

  ✖

  N/A

• Close the space

  ✔

  ✖

  N/A

• Cancel the permit

  ✔

  ✖

  N/A

• Review the job with the employer (hazards, problems, etc.)

  ✔

  ✖

  N/A

• File the completed and closed permit

  ✔

  ✖

  N/A

Recommendations

• Enter recommendations here

Completion

• Full Name and Signature of Inspector

  Sign