UMD Confined Space Hazard Evaluation

• Building Name:

• Room:

• Name of Space:

• Space Label:

• Date of Evaluation:

  Date

• Evaluator Names:

• Description of Space: (dimensions, cover type, etc.)

• Is entry allowed?

  Yes

  No

• Who enters? (contractor, employee, both)

Does this meet the definition of confined space?

• Does this space meet the definition of a confined space?<br><br>Meets ALL of the below:<br>Is large enough and can configured so that a person can enter and work.<br>Has a limited or restricted means of entry or exit.<br>Is not designed for continuous human occupancy.

  Yes

  No

Is the space a permit-required confined space?

• Is this space considered a permit-required confined space?<br><br>There are hazards associated with entering the space: potential for hazardous atmosphere, engulfment, mechanical, electrical, fall hazards are present, or the configuration of the space creates a hazard.

  Yes

  No

• This space is a non-permit required confined space. There are no hazards associated with entry. The requirements of the confined space program do not apply.
  
  STOP HERE.

Classify the confined space - Part 1

• The ONLY hazard present is the potential for hazardous atmosphere and continuous forced air ventilation can be used to ventilate and control the atmospheric hazard.<br><br>There are NO additional hazards.

  Yes

  No

• This is a TYPE 2 permit-required confined space and forced air ventilation alone is adequate to control the hazardous atmosphere. There are no additional hazards. Some sections of the permit will not apply. Refer to the confined space program for details.
  
  STOP HERE.

• Continue with Part 2 questions in order to classify.

Classify the confined space - Part 2

• Hazardous atmosphere present or there is a potential for hazardous atmosphere?

  Yes

  No

• Space configuration hazards present?

  Yes

  No

• Engulfment hazards present?

  Yes

  No

• Any additional hazards (falls, extreme temperatures, etc.)?

  Yes

  No

• List:

• Can ALL of the hazards listed in #? to #? above be controlled PRIOR to entering the space?

  Yes

  No

• This is a TYPE 3 permit required confined space. Some sections of the permit may not apply (tripod, ventilation, etc.) Refer to the confined space program for details.
  
  STOP HERE.

• This is a TYPE 1 permit-required confined space. ALL sections of the permit MUST be satisfied prior to entry.
  
  STOP HERE.

• DOES NOT NEED EVALUATION STOP HERE.