Assumptions applicable to all
exercises: 1. you and your crew have all
necessary training; 2. the monitoring instrument provided is of a constant read
variety, 3. you have a marvelous and
roomy work trailer with all of the equipment you might possibly need (you just
need to indicate what equipment is required to be set up on site); and, 4. the scenarios are
necessarily vague on some points – you need to apply the information from the
confined space training texts to each exercise and provide your crew with the
proper equipment and PPE on site.
Confined Space Exercise
MH12C
Contained in the following scenario is all of
the information you will need to complete the confined space permit following
the scenario description. On the submittal page, there will be a space
to enter the exercise number above, which has also been provided on the permit.
You are the qualified person acting as
supervisor for a crew of three persons who have been asked to service an
underground electrical relay station.
Your crew members are named Martin Short and Susan Anthony, both having
received adequate training in confined spaces and the roles of entrant and
attendant. The date of your arrival is
the date that you are completing this exercise.
Because the access to the electrical station
is via a 48" square manhole located in close proximity to the street, your
experience makes you wonder about the possibility of vehicle exhaust
accumulating in the work area. Vehicle
exhaust could cause an accumulation of carbon monoxide vapors within the
cramped quarters.
The site is located in front of the ACME building
on
1. Site roles
2. Potential for carbon monoxide accumulation
and the exposure limit of 20ppm
3. Due to the electrical problem you were on
your way to fix, the switch for the ventilation system was not functioning.
4. For the above reason, neither are the
lights.
5. That the reason all three of them, rather
than the norm of two people, were going had to do with the malfunction of the
lights and ventilation. The space would
not normally be considered a confined space because it was designed for
employee occupancy, but because of the loss of lights and air, the site no
longer had these safeguards in place.
Thus, it was being treated as a confined space entry.
Once the barricades had been erected, a Trimetre 111c multi meter with the ability to monitor
oxygen, LEL concentrations and carbon monoxide constantly and simultaneously
was used to measure the parameters of the atmosphere. The readings were O2%= 20.8, LEL= .00 and CO=
11ppm at
At this point you lowered a light into the
station and noted that the floor and walls of the manhole were wet. Torrential rains had fallen just before the
reported problems and the seal around the manhole cover was badly worn with
several areas where leakage was evident.
After ensuring that the power was locked out, you declassify the space
at
CONFINED
SPACE ENTRY PERMIT
Date:
Time
Issued: am/pm
Confined Space MH12C Expires at: am/pm
Location: Canceled
at: am/pm
Address: Canceled by: (init)
City: State:
Description of Work(Trades):_________________________________________
Outside Contractors:_________________________________________________
Acceptable
Entry Conditions:
At
or below 10% LEL
Oxygen
between 19.5% and 23.5%
Other:________________________
Isolation
Checklist: Hot
Work Permitted:
Blanking/disconnecting Welding:
Electrical Brazing:
Mechanical Grinding:
other: Open
Flame:
other:
Hazards
Expected:
Corrosive
Materials:_______________________________
Hot
Equipment:_____________________________________
Flammable
Materials:_______________________________
Toxic
Materials:___________________________________
Spark
Producing Operations:________________________
Spilled
Liquids:___________________________________
Pressure
Systems:__________________________________
Other:_____________________________________________
Vessel Cleaned: y/n time: am/pm
Method:___________________________________
Inspected by: (inits)
time: am/pm
Special Safety
Precautions:___________________________________________
______________________________________________________________________
PreEntry Personal Safety Checklist:
Constant Ventilation: y/n Respiratory
Equipment: y/n
Protective Clothing: y/n Chemical
Boots: y/n
Chemical Gloves: y/n Hard
Hat: y/n
Life Lines/Harness: y/n Tripod/Hoist: y/n
Explosion Proof Light: y/n Elec.
Polarity Check: y/n
Attendant Present: y/n Fire
Extinguishers: y/n
Emergency Response: y/n
Remarks:______________________________________________________________
______________________________________________________________________
______________________________________________________________________
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Atmospheric Gas Tests Performed: Permit
Expires when no reading is recorded within 2 hours of the previous reading.
Monitoring
Method: Continuous(preferred) or Periodic (circle one)
Monitor
Model and # (if several):___________________________________
02% LEL% Toxic% Location
Time Tests Performed By
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
____ ____
_____ _________ ___:___ __________________
Type of Entry Class
Circle one: Class A Class B
Class C
Entry Personnel Task to be Performed Time In Out
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
Attendants
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
_______________ ____________________ ___:___ ___:___
Supervisor
on Duty Time In Time Out
______________________ ___:___ ___:___
______________________ ___:___ ___:___
Communication
method(s):___________________________________________
___________________________________________________________________
I,
the undersigned, hereby authorize work in the confined space until the time
specified at the top of page 1:
Name
of Qualified Person/Supervisor_______________________________________
Signature
of Qualified Person/Supervisor_already signed by you_Time___:___
Emergency
Telephone location:___________________________________
Emergency
Telephone Number:_____________________________________
Nearest
Hospital (attach directions or designate person who is familiar with shortest
route to Hospital________________________)
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