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Confined Space Entry Checklist

Ensure worker safety with our comprehensive Confined Space Entry Checklist for Manufacturing! Stay compliant, minimize risks, and prevent accidents with this downloadable, step-by-step guide. Protect your team and streamline your confined space procedures.

This Template was installed 4 times.

Pre-Entry Planning & Authorization

NaN of 8

Verifies necessary permits, hazard assessments, and team qualifications are in place before entry.

Permit Issue Date

Permit Issue Time

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Permit Validated By (Supervisor)

Confined Space Designation

Brief Description of Entry Task

Maximum Authorized Entrants

Entry Team Roles Assigned

Hazard Assessment Document

Permit Number

Confined Space Identification & Evaluation

NaN of 8

Details the specific confined space being entered and initial hazard assessment findings.

Confined Space Name/Location

Brief Description of Confined Space

Dimensions (Length x Width x Height)

Purpose of the Confined Space (e.g., Tank Cleaning, Maintenance)

Potential Hazards Identified (Check all that apply)

Specific Hazards and their Potential Severity

Confined Space Classification (Based on initial assessment)

Date of Assessment

Hazard Identification & Control

NaN of 8

Lists identified hazards and the controls implemented to mitigate them (e.g., ventilation, lockout/tagout).

Describe Potential Hazards Identified (e.g., Oxygen Deficiency, Toxic Gases, Engulfment)

Potential Hazards Present (Select all that apply)

Describe Control Measures Implemented for Each Hazard (e.g., Ventilation, Lockout/Tagout, Isolation)

Ventilation Rate (CFM)

Lockout/Tagout Procedures Verified?

Specific Procedures for Hazard Mitigation (e.g., gas blanketing)

Residual Risk Level (After Controls)

Date of Hazard Control Verification

Time of Hazard Control Verification

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Atmospheric Monitoring & Ventilation

NaN of 8

Documents atmospheric testing results and ongoing ventilation procedures.

Atmospheric Monitoring Start Time

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Oxygen (O₂) Reading (ppm/%)

Flammable Gas/Vapor Reading (LEL%)

Hydrogen Sulfide (H₂S) Reading (ppm)

Ventilation Status

Ventilation System Description (Fan type, CFM, etc.)

Last Atmospheric Monitoring Time

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Monitoring Equipment Calibration Status

Entry Permit & Team Briefing

NaN of 8

Confirms the permit is valid, and the entry team has been briefed on roles, responsibilities, and procedures.

Permit Issue Date

Permit Issue Time

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Permit Expiration Date

Permit Expiration Time

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Permit Authorizing Supervisor

Permit Number

Briefing Summary (Team Discussion Points)

Team Roles Confirmed?

Communication Method Confirmed?

Entrant Acknowledgement

Equipment & Safety Gear

NaN of 8

Verifies proper safety equipment is available and in good working order (e.g., harnesses, lifelines, respirators).

Harness Inspection Status

Lifeline Inspection Status

Respirator Fit Test Expiration Date (MM/DD/YYYY)

Respirator Type

Lighting Equipment

PPE Check

Communication Device

Entry & Ongoing Monitoring

NaN of 8

Records observations during entry, including continuous atmospheric monitoring results and team communication.

Entry Start Time

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Oxygen Level (%)

Flammable Gas/Vapor Level (%)

Lower Explosive Limit (LEL) (%)

Atmospheric Monitoring Status

Observer Notes/Communication Log (Record all communications and significant observations)

Last Atmospheric Monitoring Time

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Unusual Occurrence?

Description of Unusual Occurrence (if Yes)

Exit & Post-Entry Procedures

NaN of 8

Details the steps taken during exit and any post-entry tasks required (e.g., equipment inspection, permit closure).

Exit Time

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Post-Entry Observations (Unusual Events, Issues)

Atmospheric Readings Upon Exit (O2, LEL, H2S, etc.)

Equipment Condition After Use (Satisfactory/Needs Repair)

Equipment Requiring Repair (Check all that apply)

Permit Expiration Date (Confirmation)

Permit Issuer Signature (Confirmation)

Corrective Actions Required (if applicable)

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