University of Michigan Appendix C Confined Space Evaluation Form 2007-2025 free printable template

APPENDIX C CONFINED SPACE EVALUATION FORM SPACE LOCATION: SPACE DESCRIPTION: Complete this form for any space which may be considered a confined space. A confined space is defined as having those

How to fill out University of Michigan Appendix C Confined Space

How to fill out University of Michigan Appendix C Confined Space Evaluation

1. Gather necessary information about the confined space, including its location and purpose.
2. Identify and evaluate the potential hazards associated with the confined space, such as oxygen deficiency, toxic gases, or engulfment risks.
3. Complete the general information section with details about the specific area being evaluated.
4. Assess the entry requirements, including necessary safety equipment and procedures.
5. Determine and document the monitoring requirements for air quality
6. Include any recommended training for personnel who will enter the confined space.
7. Review the completed evaluation for accuracy and completeness before final submission.

Who needs University of Michigan Appendix C Confined Space Evaluation?

1. Employees and contractors who will be working in confined spaces at the University of Michigan.
2. Supervisors responsible for ensuring the safety and compliance of work practices in confined spaces.
3. Safety officers or environmental health and safety personnel tasked with overseeing confined space regulations and safety measures.

People Also Ask about

What does OSHA consider a confined space?

Non-permit confined space means a confined space that does not contain or, with respect to atmospheric hazards, have the potential to contain any hazard capable of causing death or serious physical harm. Oxygen deficient atmosphere means an atmosphere containing less than 19.5 percent oxygen by volume.

What is a confined space evaluation form?

The purpose of this form is to identify the hazards and characteristics of a space to determine if it is a non-permit required space or a permit-required confined space. This assessment does not replace a Confined Space Entry Permit.

What are the 4 factors for confined space?

These can be defined within four main areas – physical hazards, toxic atmosphere, flammable atmosphere and engulfment.

What 3 requirements must be met for a space to be considered a confined space?

In order for a work area to be defined as a confined space it must meet all three of the following criteria: Limited Openings for Entry and Exit. The Space is not Intended for Continuous Human Occupancy. The Space is Large Enough for You to Enter and Conduct Work.

How do you write a risk assessment for a confined space?

Confined Space Risk Assessment Template Assess the risks associated with the access area, atmosphere, electrical equipment used, and PPE. Describe emergency processes to be taken during worst-case scenarios. Attach media-based evidence and create corrective actions to risks that are to be prioritized.

What must be reviewed and approved prior to entering a confined space?

Before an employee enters the space, the internal atmosphere shall be tested, with a calibrated direct-reading instrument, for oxygen content, for flammable gases and vapors, and for potential toxic air contaminants, in that order.

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What is University of Michigan Appendix C Confined Space Evaluation?

The University of Michigan Appendix C Confined Space Evaluation is a document used to assess and identify confined spaces on campus to ensure safety and compliance with regulations regarding entry and work in such spaces.

Who is required to file University of Michigan Appendix C Confined Space Evaluation?

Employees or contractors who plan to enter or work in a confined space at the University of Michigan are required to file the Appendix C Confined Space Evaluation.

How to fill out University of Michigan Appendix C Confined Space Evaluation?

To fill out the University of Michigan Appendix C Confined Space Evaluation, individuals must provide details regarding the confined space location, nature of work to be performed, hazards identified, and any safety measures to be implemented.

What is the purpose of University of Michigan Appendix C Confined Space Evaluation?

The purpose of the University of Michigan Appendix C Confined Space Evaluation is to ensure the safety of individuals entering confined spaces, to identify potential hazards, and to establish proper safety protocols and procedures.

What information must be reported on University of Michigan Appendix C Confined Space Evaluation?

The information that must be reported on the University of Michigan Appendix C Confined Space Evaluation includes the location of the confined space, the type of work to be done, identified hazards, and emergency response procedures.