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 MH10A
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 repair a sewer manhole by casting a concrete liner inside
the existing manhole. Your crew members
are named Betsy Ross and Barnaby Jones, 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.
Prior
to leaving for the site, you look over the site information for the work to be performed
and the hazard characteristic sheet provided by your company.
The
work is for the Anytown Sewer Department and the manhole is located near
Your
company’s hazard information sheet gives you the following information:
expected hazards include methane gas (fire/explosion hazard) and potential
exposure to biologically active toxins (capable of causing disease or
infection). Methane gas has a vapor
density somewhat greater than 1 so ventilation will have to remove vapors from
the lowest areas of the manhole.
Monitoring instrument readings will be required as close to the manhole
bottom as possible as well as at various points in the middle and top of the
manhole because the vapors are light enough to mix into the ambient
atmosphere. Trace amounts of hydrogen
sulfide (h2s) may be present and carbon monoxide (co) and carbon dioxide (co2)
are decomposition products common in sewer work. Since the presence of carbon dioxide presents
no problem so long as it is not present in quantities large enough to displace
oxygen, the measurement of toxic atmospheric constituents will be limited to
h2s and co. Limits for confined space
entry of 10 ppm of CO and 10 ppm of H2S are determined. Supplied air respirators will be required
until sufficient information has been gathered to show that air-purifying
respirators (full face) with organic filter cartridges will be protective. Spark and flame producing operations are not
to be conducted in areas where methane vapors might accumulate. You expect the duration of the work to be
between 1.5 to 3 hours depending on the physical condition of the manhole
before it will be safe to declassify the space to non-permit required and allow
the placement of concrete forms and pouring of the concrete liner to commence.
You
check out the Industrial Scientific TMX 412 - #7 multi meter from the equipment
room and check the calibration using a calibration gas kit in the equipment
room. After verifying the functionality
of the meter, you proceed to your work truck where you meet your crew and
review the load out list for the truck.
You leave for the site at
You
arrive at the manhole at
At
Barnaby
dons his respirator and begins climbing down the ladder rungs into the manhole
while Betsy manages his air line and the lifeline attached to his harness. Once Barnaby is in the manhole the explosion
proof light is carefully hung inside the manhole and the monitor is lowered
down to Barnabe who then takes readings at the manhole bottom to confirm the
readings taken from outside the manhole at
Betsy
and Barnaby, who showed no visible signs of contamination, don their
air-purifying respirators and begin assembling the concrete forms. You call for concrete delivery immediately
after lunch. Periodically you use the
monitoring instrument to assure that the atmosphere is still safe and, once the
forms are in place, you help Barnaby and Betsy decontaminate for lunch.
CONFINED
SPACE ENTRY PERMIT
Date: Time
Issued: am/pm
Confined Space - UST17A 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% CO H2S
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___attached______________)
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