OSHA estimates that each year, 2.1 million Americans will enter a confined space at work and 100 won’t come home. Of these 100 deaths, about 61% are from simple mistakes during construction or routine maintenance. Avoid these kinds of workplace accidents by using more complete training and thorough entry preparation. The first step in preparing to enter a confined space is the pre-entry checklist used to identify any potential hazards and determine if a permit is required. Please remember that during the pre-entry check, communication is a worker’s best chance for survival and at least two employees must be onsite during work in confined spaces.
While completing the pre-entry check, a permit is necessary if any of the following is occurring: detection of a hazardous atmosphere; the space contains a material that has engulfing potential; it’s an extremely tight entrance or any other serious safety hazard. A permit for certified confined spaces can be found in Appendix D of subpart J in OSHA’s 1910 Safety Regulations.
Confined Space Pre-Entry Checklist
I. General Information
Space Type/Manhole Identification: _________________________________
Date/Time: _______________
Shop: _____________________
Employee Names: _____________________________________________
II. Non-Permit Required Confined Space Pre-Entry Checklist
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Potential Hazard
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Yes, this is a potential hazard
identified in the initial confined
space classification
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Is this potential hazard secured,
eliminated, or if applicable is
monitoring being performed?
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Atmospheric hazard
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Mechanical hazard
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Electrical hazard
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Thermal hazard
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Noise hazard
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Vibration hazard
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Fire or explosion hazard
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Engulfment/Entrapment hazard
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Materials harmful to skin
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List Other Potential Hazards
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Yes, this is a potential hazard identified in the initial confined space classification
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Is this potential hazard secured, eliminated, or if applicable is monitoring being performed?
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If any of the initial identified potential hazards are active hazards as indicated by a “No” answer above, then this space shall be reclassified as a Permit-Required Confined Space. A non-permit required confined space might also require reclassification based on the type of work to be performed in the space, for example, welding.
Comments: __________________________________________________________________________
______________________________________________________________________________
If an atmospheric hazard is indicated as a potential hazard in Section II above, a direct reading gas monitor shall be used to check the atmosphere and the results shall be listed below. If conditions are not acceptable the space shall be reclassified as a Permit Required Confined Space.
III. Atmospheric Hazard Data
Please collect and document pre-entry readings in the specified order when a potential atmospheric hazard exists:
- At surface after the cover is removed
- 3 feet from the surface
- 6 feet from the bottom
- 3 feet from the bottom
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Acceptable Conditions
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O2
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%O2
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%O2
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%O2
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% O2
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>19.5% and < 23.5% O2
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Explosive
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%LFL
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%LFL
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%LFL
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%LFL
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<10% LFL
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Toxic
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ppm CO
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ppm CO
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ppm CO
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ppm CO
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< 25 ppm CO
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ppm H2S
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ppm H2S
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ppm H2S
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ppm H2S
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<10 ppm H2S
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Time Sampled: ____________________________
Tester Signature and Date: ___________________________________________
Instrument Name/Serial Number: ______________________________________
Instrument Calibration Date: ____________________________