Non-Permit Confined Space Entry

Non-Permit Confined Space Entry
Osha's definition of a confined space.

1910.46.(b)

Confined space means a space that:

(1) Is large enough and so configured that an employee can bodily enter and perform assigned work; and

(2) Has limited or restricted means for entry or exit (for example, tanks, vessels, silos, storage bins, hoppers, vaults, and pits are spaces that may have limited means of entry.); and

(3) Is not designed for continuous employee occupancy.
Status
Is this a Subcontractor or IWS employee/affiliate filling out the form
State
Project Name
Project Number
Reason For Cancellation
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Entry Supervisor

First NameLast Name
Entry Supervisor Email
example@example.com
Authorized Entrant(s)
Authorized Attendant(s)
Entry Location
be specific
Reason for Entry
Expected Duration of Entry
Is this a printed/paper permit?
Upload printed permit or any supplementary documents

Browse Files

Cancelof
Atmospheric Test Results
% of Oxygen (allowable level 19.5% to 23.5%):
% LEL (allowable level 0%):
Carbon Monoxide (allowable level 0%)
Hydrogen Sulfide (allowable level 0%)
Confined Space Evaluation
1. Is the gas monitor current on calibrations
2. Are test readings within the "Allowable Level"
3. Is there a material that can engulf the entrant
4. Could entrant be trapped, crushed or smothered
5. Are there any additional uncontrolled safety hazards present
6. Can the space be maintained as safe during work
7. Are the entrants properly trained
8. Are the attendants properly trained
9. Are rescue procedures and equipment available
10. Are attendants rotated every two hours
*STOP*

Based on the above answers you provided, a Confined Space Entry Permit IS required. Please proceed with your plan by first meeting all the requirements of the Confined Space Entry Permit.
Acceptance
Entry Supervisor (ES) Hand Typed Name Acts as Approval
Please print AS Name Here
Should be Empty:

Non-Permit Confined Space Entry

Atmospheric Test Results

Confined Space Evaluation

Acceptance