TVA - Confined Space Entry Program Self Assessment Checklist

• Document No.

• Audit Title

• Plant or Faclity:

  COLBERT Fossil Plant

  COLBERT CT

• Unit(s) [if applicable]

  Select 1 2 3 4 5

  • 1
  • 2
  • 3
  • 4
  • 5

• Conducted on:

  Date

• Prepared by:

• Team Members:

General Requirements for Entry into Permit Spaces:

• Has the workplace been formally evaluated to determine if any Confined Spaces exist?

  YES

  NO

  Not Applicable

• Comment:

• Are all Confined Spaces listed in the Site Confined Space Inventory & Evaluation Form?

  YES

  NO

  Not Applicable

• Comment:

• For each space listed on the Inventory, are hazards identified and evaluated and has a Confined Space Evaluation Report verified and then eliminated or controlled?

  YES

  NO

  Not Applicable

• Comment:

• Prior to entry, are the hazards listed on the Evaluation Report verified and then eliminated or controlled?

  YES

  NO

  Not Applicable

• Comment:

• Have exposed employees been informed of the existence and dangers posed by Confined Spaces on site?

  YES

  NO

  Not Applicable

• Comment:

• Are Confined Spaces, which can be readily entered, identified by DANGER signs, or by any other equally effective means? (Confined Spaces such as piping systems or man-ways with multiple bolts may not necessarily require such signs).

  YES

  NO

  Not Applicable

• Comment:

• If employees will not enter Confined Spaces, have effective measures been taken to prevent entry?

  YES

  NO

  Not Applicable

• Comment:

• Are the means, procedures, and practices necessary for safe permit space entry operations developed and implemented?

  YES

  NO

  Not Applicable

• Comment:

Review of Completed Entry Permits:

• Was a rescue plan specified and described on the permit?

  YES

  NO

  Not Applicable

• Comment:

• Where means for summoning rescue identified and functionally tested?

  YES

  NO

  Not Applicable

• Comment:

• Was Rescue IN USE? (Non-entry retrieval set up with a trained attendant or entry rescue equipment staged at the entry portal?

  YES

  NO

  Not Applicable

• Comment:

• Where enough rescuers available for the entry operation?

  YES

  NO

  Not Applicable

• Comment:

• Did the Rescue Team pre-plan the Permit Space?

  YES

  NO

  Not Applicable

• Comment:

• Where acceptable entry conditions specified?

  YES

  NO

  Not Applicable

• Comment:

• Where Engineering and work practice controls specified?

  YES

  NO

  Not Applicable

• Comment:

• Was PPE (Personal Protective Equipment) properly specified for the hazards present?

  YES

  NO

  Not Applicable

• Comment:

• If Respiratory Protection was specified was ventilation in use to minimize the atmospheric hazard(s)?

  YES

  NO

  Not Applicable

• Comment:

• Was the atmospheric monitoring data readily available for review by employees (evidence of posting)?

  YES

  NO

  Not Applicable

• Comment:

• If an initial entry is required to obtain the data above, is the entry made under the written permit space program?

  YES

  NO

  Not Applicable

• Comment:

• Has the Entry Supervisor and Atmospheric Evaluator properly evaluated ALL of the hazards of the space? Are "eliminated" hazards truly isolated?

  YES

  NO

  Not Applicable

• Comment:

• Other than atmospheric, are hazards listed on the Evaluation Report that are not eliminated?

  YES

  NO

  Not Applicable

• Comment:

• Once the entrance is removed, is the opening protected by a railing, temporary cover, or barrier that will prevent an accidental fall through the opening and that will protect each employee working in the space from foreign objects entering the space?

  YES

  NO

  Not Applicable

• Comment:

• Prior to an employee entering the space, is the internal atmosphere tested with a calibrated direct reading instrument?

  YES

  NO

  Not Applicable

• Comment:

• Is monitoring done in the following order: Oxygen content, Flammable Gases and Vapors, and then potential toxic air contaminants?

  YES

  NO

  Not Applicable

• Comment:

• When the employee enters the space, is the atmosphere inside of the space free from all contaminants?

  YES

  NO

  Not Applicable

• Comment:

• Is natural or continuous forced air ventilation alone sufficient to maintain the space safe for entry?

  YES

  NO

  Not Applicable

• Comment:

• Is the atmosphere inside of the space periodically tested, as necessary, to ensure that natural or continuous forced air ventilation is preventing the accumulation of a hazardous atmosphere?

  YES

  NO

  Not Applicable

• Comment:

IF Continuous Forced Air Ventilation Is Used:

• Has the continuous forced air ventilation eliminated any hazardous atmosphere before an employee enters the space?

  YES

  NO

  Not Applicable

• Comment:

• Is the continuous forced air ventilation so directed as to ventilate the immediate areas where an employee is or will be present within the space?

  YES

  NO

  Not Applicable

• Comment:

• Is the forced air ventilation continued until all employees have left the space?

  YES

  NO

  Not Applicable

• Comment:

• Is the air supply for the forced air ventilation from a clean source hat does not increase the hazards in the space?

  YES

  NO

  Not Applicable

• Comment:

IF a Hazardous Atmosphere is Detected During The Entry:

• Do all employees exit the space immediately?

  YES

  NO

  Not Applicable

• Comment:

• Is the space evaluated to determine how the hazardous atmosphere developed?

  YES

  NO

  Not Applicable

• Comment:

• Are measures implemented to protect employees from the hazardous atmosphere before any subsequent entry takes place?

  YES

  NO

  Not Applicable

• Comment:

• Is the space verified safe for entry, using a written certification form?

  YES

  NO

  Not Applicable

• Comment:

• Is the Confined Space Evaluation Report completed prior to entry?

  YES

  NO

  Not Applicable

• Comment:

• Does the Confined Space Evaluation Report contain the date, the location of the space, and the signature of the person providing the verification?

  YES

  NO

  Not Applicable

• Comment:

• Is the Confined Space Evaluation Report made available to each employee entering the space?

  YES

  NO

  Not Applicable

• Comment:

NON-PERMIT ENTRY

• If there are changes in the use or configuration of a non-permit required confined space that might increase the hazards to entrants, are the spaces re-evaluated and, if necessary, reclassified as permit required confined space?

  YES

  NO

  Not Applicable

• Comment:

• Do any of the non-permit confined spaces pose any actual or potential atmospheric or physical hazards?

  YES

  NO

  Not Applicable

• Comment:

• If it is necessary to enter the space to eliminate hazards, is the entry initially made under the permit required program?

  YES

  NO

  Not Applicable

• Comment:

• Is written certification via the Hazard Evaluation Report available listing the basis for determining that ALL hazards in a permit space have been eliminated if it was down-graded to a non-permit confined space?

  YES

  NO

  Not Applicable

• Comment:

• Is the Hazard Evaluation Report posted at the entry portal for a Non-Permit Space and available to each employee entering the space?

  YES

  NO

  Not Applicable

• Comment:

• If hazards arise in a space that has been re-classified as a non-permit required Confined Space, do all employees exit the space?

  YES

  NO

  Not Applicable

• Comment:

• If a non-permit required space has to be evacuated, is the space re-evaluated to determine whether it must be reclassified as a Permit-Required Confined Space?

  YES

  NO

  Not Applicable

• Comment:

Contractor Entry

• Are measures in place that will prevent unauthorized entry into Confined Space by supplier/contractor personnel?

  YES

  NO

  Not Applicable

• Comment:

• Have suppliers/contractors been informed that the workplace contains Confined Spaces, and that confined space entry is allowed ONLY through compliance with the site's written Confined Space Entry Program or equivalent?

  YES

  NO

  Not Applicable

• Comment:

• Does the contractor obtain any available information regarding Confined Space Hazards and entry operations from the job sponsor or site?

  YES

  NO

  Not Applicable

• Comment:

• Has the contractor been apprised of the elements, including the hazards identified and historical experiences with the space that makes the space a Permit Space?

  YES

  NO

  Not Applicable

• Comment:

• Has the contractor been apprised of any precautions or procedures that have been implemented for the protection of employees in or near confined spaces where the contractor personnel will be working?

  YES

  NO

  Not Applicable

• Comment:

• Has the contractor demonstrated that the contractor personnel, that will be expected to enter confined spaces, have been properly trained?

  YES

  NO

  Not Applicable

• Comment:

• Are entry operations coordinated with the contractor, when both site employees and contract personnel will be working in or near confined spaces?

  YES

  NO

  Not Applicable

• Comment:

• Does the contractor coordinate entry operations with the job sponsor, when both site personnel and contractor personnel will be working in or near a confined space?

  YES

  NO

  Not Applicable

• Comment:

• If applicable, does the contractor inform and allow the job sponsor to review the Confined Space Entry Program that the contractor will follow (if different) and of any hazards confronted or created in permit spaces, either through a job planning, pre-job briefing, during the entry operations, or during a job debriefing?

  YES

  NO

  Not Applicable

• Comment:

• Is the contractor debriefed at the conclusion of the entry operation regarding the Confined Space Entry Program that was followed and questioned regarding any hazards confronted or created in permit spaces during entry operations?

  YES

  NO

  Not Applicable

• Comment:

Confined Space Reacue

• Are procedures developed and implemented for summoning rescue and emergency services?

  YES

  NO

  Not Applicable

• Comment:

• Are procedures developed and implemented for rescuing entrants from permit spaces, and for providing necessary Emergency Services to rescued employees?

  YES

  NO

  Not Applicable

• Comment:

• Are procedures developed and implemented that prevent unauthorized personnel from attempting rescue?

  YES

  NO

  Not Applicable

• Comment:

• Is a system developed and implemented for the preparation, issuance, use, and cancellation of entry permits?

  YES

  NO

  Not Applicable

• Comment:

• Has the outside service been evaluated as to its ability, qualifications, equipment and willingness to provide the needed response?

  YES

  NO

  Not Applicable

• Comment:

• Is the evaluation documented and on file as part of the site's written Confined Space Entry Program?

  YES

  NO

  Not Applicable

• Comment:

• Has the outside service visited the plant during the past year, made aware of the types of spaces they may have to enter to perform a rescue, and given the opportunity to practice rescue techniques at the plant?

  YES

  NO

  Not Applicable

• Comment:

Active Confined Space Entry Observation

• (Two active confined space entries must be selected and observed for this evaluation.)

• Is the space clearly identified as a Permit Required Confined Space?

  YES

  NO

  Not Applicable

• Commented:

• Is a Confined Space Permit posted at the access? (If more than one access, are copies posted at each, and are sufficient means employee to prevent unauthorized entry?)

  YES

  NO

  Not Applicable

• Commented:

• Is atmospheric monitoring being conducted in the space? If an air monitor is being used, is it being used correctly?

  YES

  NO

  Not Applicable

• Commented:

• Are the conditions in the permit space verified to be acceptable for the entry, throughout the duration of an authorized entry?

  YES

  NO

  Not Applicable

• Commented:

• Is the Entry Permit current? Verify using the time constraints identified on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

• Are spaces isolated?

  YES

  NO

  Not Applicable

• Commented:

• Are atmospheric hazards controlled or eliminated by purging, flushing, or through ventilation?

  YES

  NO

  Not Applicable

• Commented:

• Are work processes on-going in the space listed on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

Are Permit Space Conditions Evaluated as Follows When Entry Operations are Conducted?

• Test conditions in the permit space to determine if acceptable entry conditions exist before entry is authorized to begin?

  YES

  NO

  Not Applicable

• Commented:

• Test or monitor the permit space, as necessary, to determine if acceptable entry conditions are being maintained during the course of entry operations?

  YES

  NO

  Not Applicable

• Commented:

• Has permission been granted to enter the space by an Entry Supervisor? Verify signature.

  YES

  NO

  Not Applicable

• Commented:

• Are all protective measures being utilized, as identified on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

• Do the protective measures provide adequate protection of entrants?

  YES

  NO

  Not Applicable

• Commented:

• Is access/egress adequate?

  YES

  NO

  Not Applicable

• Commented:

• Is the access point unobstructed?

  YES

  NO

  Not Applicable

• Commented:

• Is lighting adequate?

  YES

  NO

  Not Applicable

• Commented:

• Is communication adequate?

  YES

  NO

  Not Applicable

• Commented:

• Is ventilation adequate?

  YES

  NO

  Not Applicable

• Commented:

• Are all employees in the space appropriately logged in?

  YES

  NO

  Not Applicable

• Commented:

• Is at least one authorized attendant provided outside the permit space, into which entry is authorized, for the duration of entry operations?

  YES

  NO

  Not Applicable

• Commented:

• Are good housekeeping practices being observed?

  YES

  NO

  Not Applicable

• Commented:

• Is the area free from on-going work processes that may create hazards to employees in the space?

  YES

  NO

  Not Applicable

• Commented:

• Where applicable, is emergency rescue equipment available at entrance?

  YES

  NO

  Not Applicable

• Commented:

• Where utilized, are life lines attached to a substantial structure?

  YES

  NO

  Not Applicable

• Commented:

• Where needed, are adequate controls (e.g. barricade, ropes, warning tapes and/or signs) being utilized?

  YES

  NO

  Not Applicable

• Commented:

• Does the location of emergency equipment correspond to what is entered on the Entry Permit? Physically verify.

  YES

  NO

  Not Applicable

• Commented:

• Does the location of the nearest phone (if applicable) correspond to what is entered on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

• Does the phone or radio being used for Emergency purposes work properly? Physically verify.

  YES

  NO

  Not Applicable

• Commented:

• Have Entrants read the (or had explained to them) Confined Space Permit and it's requirements?

  YES

  NO

  Not Applicable

• Commented:

• Do they understand the existing/potential hazards associated with space?

  YES

  NO

  Not Applicable

• Commented:

• Do they understand the protective measures?

  YES

  NO

  Not Applicable

• Commented:

• Are protective measures being utilized?

  YES

  NO

  Not Applicable

• Commented:

• Is the Entry Supervisor accessible? Verify by use of phone or radio to contact.

  YES

  NO

  Not Applicable

• Commented:

• At other permits or documentation (Hot Work, MSDS, etc.) available at the space, as identified on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

• If the work activity involves welding, are special considerations being followed, such as ventilation and respirator use?

  YES

  NO

  Not Applicable

• Commented:

• Are the Entrants/Welders using a full body harness and lifeline to enhance rescue?

  YES

  NO

  Not Applicable

• Commented:

• Is the tripod or other device in place to promote non-entry rescue by the attendant or personnel outside the space?

  YES

  NO

  Not Applicable

• Commented:

• Is forced ventilation established to prevent the accumulation of toxic materials or possible oxygen deficiency?

  YES

  NO

  Not Applicable

• Commented:

• Is the monitoring frequency consistent with what is identified on the Entry Permit?

  YES

  NO

  Not Applicable

• Commented:

• Have the instruments being used for atmospheric testing been calibrated? Use Instrument ID number to verify.

  YES

  NO

  Not Applicable

• Commented:

• Are all compensatory measures, as identified on the Entry Permit, in use?

  YES

  NO

  Not Applicable

• Commented:

• Are identified measures appropriate for the hazards encountered within the space?

  YES

  NO

  Not Applicable

• Commented:

• Is the current Attendant identified on either the Entry Permit or Supplemental Log Sheet?

  YES

  NO

  Not Applicable

• Commented:

• Has the Attendant been properly trained in their roles and responsibilities?

  YES

  NO

  Not Applicable

• Commented:

• Has a copy of the Entry Permit been delivered to Operations?

  YES

  NO

  Not Applicable

• Commented:

• Does a Confined Space Hazard Evaluation Report exist for the space name and location?

  YES

  NO

  Not Applicable

• Commented:

• Are all persons involved with the entry process properly trained (i.e. Entrants, attendants, authorizing person, HA) Verify by training records.

  YES

  NO

  Not Applicable

• Commented:

• Do the employees working in the space demonstrate understanding of the Confined Space Entry Program?

  YES

  NO

  Not Applicable

• Commented:

Organizational Effectiveness

• This section can be be used to evaluate how well the Confined Space Entry Program is implemented and supported by management. Focus should be on process issues, not compliance.

• Does a process ensure that corrective actions are developed and implemented for deficiencies identified during program evaluations or incident investigations are implemented, documented, and communicated to management?

  YES

  NO

  Not Applicable

• Comment:

• Does a process ensure that Confined Spaces are adequately evaluated and made safe prior to entry?

  YES

  NO

  Not Applicable

• Comment:

• Does a process ensure that air monitors used in Confined Spaces are calibrated and bump tested as required by the manufacturer?

  YES

  NO

  Not Applicable

• Comment:

• Does a process ensure that contractors are informed of the:<br>* Hazards associated with Confined Space Entry Job?<br>* Applicable Confined Space Program?<br>* Applicable Emergency procedures for Confined Space Entries?

  YES

  NO

  Not Applicable

• Comment:

• Does a process ensure that contract employees have been trained for Confined Space Entry?

  YES

  NO

  Not Applicable

• Comment:

• Does a process exist to ensure the following personnel have been identified and trained in their roles and responsibilities regarding Confined Spaces?<br>* Entrant<br>* Attendant<br>* Authorizing Persons<br>* Authorized Hazard Analyzer<br>* Other affected personnel

  YES

  NO

  Not Applicable

• Comment:

• Have the appropriate individuals, i.e., those most familiar with the work processes to be performed during the entry, been selected to serve as Entry Supervisor?

  YES

  NO

  Not Applicable

• Comment:

• Does a process ensure that outside rescue services are kept aware of the types of Confined Spaces, and their hazards, in which they may be called upon to perform a Confined Space Rescue?

  YES

  NO

  Not Applicable

• Comment:

• Are outside rescue services that have been designated to perform, or provide support for, Confined Space Rescues given the opportunity to train on those spaces at the plant?

  YES

  NO

  Not Applicable

• Comment: