Audit

1.Criteria for a Confined Space

1(a). Is this an area that was not designed for continuous human occupancy.

It is a confined space

2(a). Area can be bodily entered and assigned work performed.

It is a confined space

3(a). Area has limited and/or restricted means of access and egress.

It is a confined space

2. Classification of the Confined Space

2. (a) Does the space have or reasonably have the potential for a hazardous atmosphere?

4 (i). If yes it is a Class "A" Confined Space, please mark the hazard(s) below:

Oxygen Deficiency

Oxygen Enrichment

Explosive Gas/Vapor

Explosive Dust

Hydrogen Sulfide

4(i)(f). Carbon Monoxide

2(b) Does the space have the potential to engulf the entrant?

If yes it is a Class "A" Confined Space, please mark the hazard(s) below:

Water

Sand

Soil

Gravel/Loose Rock

Sewage

Oil

Other

Describe hazard

2. (c) Does the space have the potential to entrap the entrant?

Describe the risk

2. (d) Is there a reasonable potential for any other serious safety and health hazard?

Electrical

Moving Parts

Slips and Trips

Falling (more than 5 ft)

Extreme Heat (above 100 degrees F)

Cold

Noise

Chemicals

2. (e) Is the entry or is there access by any part of the confined space restricted by 2 feet or less

Describe the condition

2. (f) Is the entry or access in the confined space larger than 2 feet but less than 4 feet?

FINAL DETERMINATION

Was "yes" answered to any of questions in section 2 (a) thru 2(d) "Criteria for a Confined Space"?

This is a class "A" Confined Space

Is a top entry required to access the space?

Entry is not allowed by RHC Staff a contractor must be scheduled to complete work in confined space

What was the response to question 2. (e)?

This is a Class "B" Confined Space

What was the response to question 2. (f)?

This is a Class"C" Confined Space

Non IDLH Hazards and Control Measures

Sharps/cuts/punctures/abrasion

Description

Control Measure

Add media

Noise

Description

Control Measure

Add media

Pressurized system/compressed gas

Description

Control Measure

Add media

Obstruction(s)

Control Measure

Description

Add media

Fire / Explosion / Flammable

Description

Control Measure

Burns

Description

Control Measure

Add media

Dusts/ Fumes/ Vapors

Description

Control Measure

Add media

Asbestos

Description

Control Measure

Add media

Poor visibility

Description

Control Measure

Add media

Working Alone

Description

Control Measure

Add media

Hearing

Control Measure

Description

Add media

Other

Description

Control Measure

Add media

Summary of Findings

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.