Pre-entry verification checklist for permit-required confined spaces under 29 CFR 1910.146
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| # | Checklist Item | Requirement | Verified (Y/N) | Reading / Detail | Notes |
|---|---|---|---|---|---|
| Space Identification and Hazards | |||||
| 1 | Space number and location confirmed | ||||
| 2 | Reason for entry documented | ||||
| 3 | Hazards identified (atmospheric, engulfment, energy, other) | ||||
| 4 | Previous entry permits reviewed | ||||
| Isolation and Securing | |||||
| 5 | Electrical energy locked out and tagged | ||||
| 6 | Mechanical energy locked out and tagged | ||||
| 7 | Piping blanked or disconnected | ||||
| 8 | Space drained or purged as required | ||||
| 9 | Isolation verification completed | ||||
| Atmospheric Testing | |||||
| 10 | Gas monitor calibrated (date confirmed) | ||||
| 11 | Oxygen level top (19.5-23.5%) | ||||
| 12 | Oxygen level middle (19.5-23.5%) | ||||
| 13 | Oxygen level bottom (19.5-23.5%) | ||||
| 14 | Combustible gas LEL top (below 10%) | ||||
| 15 | Combustible gas LEL middle (below 10%) | ||||
| 16 | Combustible gas LEL bottom (below 10%) | ||||
| 17 | H2S reading (below 10 ppm) | ||||
| 18 | CO reading (below 25 ppm) | ||||
| 19 | Continuous monitoring plan confirmed | ||||
| Ventilation | |||||
| 20 | Ventilation type (natural or mechanical) | ||||
| 21 | Ventilation equipment positioned correctly | ||||
| 22 | Airflow rate adequate for space volume | ||||
| 23 | Ventilation running before entry confirmed | ||||
| Rescue and Communication | |||||
| 24 | Rescue method identified (self / non-entry / entry) | ||||
| 25 | Rescue team or service confirmed available | ||||
| 26 | Retrieval system set up (tripod, winch, harness) | ||||
| 27 | Communication method confirmed (voice, radio, visual) | ||||
| 28 | Emergency contact numbers posted | ||||
| Personnel and PPE | |||||
| 29 | Entry supervisor named and briefed | ||||
| 30 | Attendant stationed at entry point | ||||
| 31 | All entrants trained and briefed | ||||
| 32 | Respiratory protection issued (if required) | ||||
| 33 | Harness and retrieval line fitted to entrant | ||||
| 34 | Head protection and additional PPE confirmed | ||||
I confirm that all items have been inspected/completed as indicated above. Any defects or concerns have been noted and reported.