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Confined Space Entry Permit Date Permit Number Space Number to Enter Entry Supervisor Location and Type of Space (e.g. vault, manhole, etc.) Attendant(s) Purpose of Entry Work Order Number Authorized
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How to fill out confined space entry permit

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How to fill out confined space entry permit:

01
Begin by filling out the heading of the permit, including the date, time, and location of the entry. This information is crucial for identifying the specific confined space and ensuring accurate record keeping.
02
Provide details about the purpose of the entry, such as maintenance, inspection, or repairs. Specify any specific tasks that will be conducted inside the confined space.
03
Identify the confined space by providing its name, description, and location. Include any potential hazards or specific precautions that should be taken while working in the space.
04
List the names and job titles of individuals who will be involved in the entry, including workers, supervisors, and any authorized personnel. This helps to ensure accountability and responsibility.
05
Outline the safety measures that will be implemented during the entry, such as the use of personal protective equipment, atmospheric testing, ventilation, and communication protocols. Include details about the equipment that will be used, such as gas monitors or breathing apparatus.
06
Specify any necessary permits or licenses required for the entry, such as hot work permits or confined space entry certifications. Provide evidence of any training or certifications obtained by workers involved in the entry.
07
Include an emergency response plan, detailing the procedures to follow in the event of an incident or accident inside the confined space. This should include evacuation routes, emergency contacts, and medical assistance arrangements.
08
Obtain signatures from all individuals involved in the entry, including workers, supervisors, and any authorized personnel. This serves as confirmation of their understanding and agreement to adhere to the specified entry procedures.
09
Once completed, retain a copy of the filled-out confined space entry permit on-site and ensure it is readily accessible for reference during the entry. It may also be necessary to submit a copy to relevant authorities or stakeholders.

Who needs confined space entry permit?

01
Employers or site owners who have identified confined spaces within their premises that require periodic entry for maintenance, inspection, or repairs.
02
Workers who will be performing tasks inside these confined spaces, including contractors, subcontractors, and employees.
03
Safety professionals, supervisors, or authorized individuals responsible for overseeing and approving confined space entries.
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A confined space entry permit is a document that outlines the precautions and procedures needed to safely enter and work in a confined space.
Workers who need to enter a confined space are required to file a confined space entry permit.
To fill out a confined space entry permit, you need to provide information about the location of the confined space, hazards present, precautions to be taken, and the duration of work.
The purpose of a confined space entry permit is to ensure that workers are aware of the hazards present in a confined space and have taken appropriate precautions to work safely.
Information that must be reported on a confined space entry permit includes the location of the confined space, hazards present, precautions taken, and the names of workers entering the space.
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