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APPENDIX D UNIVERSITY OF MICHIGANDEARBORN CONFINED SPACE ENTRY PERMIT (Valid for maximum of one eight-hour shift and to be posted at work site) Type of Entry Permit (check one): General: Hazardous:
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How to fill out confined space entry

How to fill out confined space entry:
01
Gather necessary information: Before filling out the confined space entry form, gather all the relevant information about the specific confined space, including its location, purpose, potential hazards, and any safety precautions that should be taken.
02
Identify and assess the hazards: Evaluate the potential risks associated with entering the confined space. This could include oxygen deficiency or enrichment, toxic gas exposure, flammable atmospheres, physical hazards, and any other specific dangers. It is crucial to document these hazards accurately in the entry form.
03
Develop a comprehensive plan: Create a detailed plan for how the confined space entry will be conducted safely. This should include identifying necessary equipment, establishing communication procedures, ensuring proper training of workers involved, and detailing rescue procedures. Be sure to document all aspects of the plan in the entry form.
04
Obtain necessary approvals: Seek approval from the appropriate authorities, such as management, supervisors, and safety professionals, before initiating the confined space entry. This is vital to ensure all necessary precautions have been taken and everyone is aware of the potential risks involved.
05
Complete the entry form accurately: Use the provided confined space entry form and fill out all the required fields accurately and comprehensively. This may include information such as the date and time of entry, identification of workers involved, details of the confined space, hazard assessment, control measures implemented, and any special permits or authorizations required.
Who needs confined space entry:
01
Construction workers: Construction sites often have confined spaces such as manholes, tunnels, or crawl spaces that require entry for maintenance, inspections, or repairs. Workers involved in these activities need confined space entry protocols to ensure their safety.
02
Maintenance personnel: Various industries, such as manufacturing plants, oil refineries, or chemical facilities, have confined spaces that require frequent maintenance. Maintenance workers must follow confined space entry procedures to protect themselves from potential hazards.
03
Emergency response teams: In case of accidents or incidents occurring in confined spaces, emergency response teams may need to enter those spaces to rescue trapped individuals or mitigate further risks. Proper confined space entry protocols are crucial for their safety and for effectively carrying out their rescue missions.
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What is confined space entry?
Confined space entry refers to the process of entering and working in a space that is not intended for continuous occupancy, has limited access or egress, and may pose a risk to the workers inside.
Who is required to file confined space entry?
Employers or organizations that have workers entering confined spaces are required to file confined space entry.
How to fill out confined space entry?
Confined space entry forms can be filled out by providing information about the location, purpose of entry, hazards present, safety measures taken, and emergency procedures.
What is the purpose of confined space entry?
The purpose of confined space entry is to ensure that workers are aware of the hazards present in confined spaces and take necessary precautions to prevent accidents and injuries.
What information must be reported on confined space entry?
Information such as the location of the confined space, date and time of entry, number of workers entering, hazards present, safety equipment used, and emergency procedures must be reported on confined space entry forms.
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