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FEB 05 '99 14:45 FR CONTAINMENT SOLUTIONS814 542 5020 TO 9-15108958426 F. 14.-20 ENTRY PERMIT FOR'PERMIT REQUIRED SPACES Location: Description of confined area: Permit number: 1 Permit date.- Description ate:Description of work: Time issued: Time expired: Required if ENTRY CHECKLIST: to be completed by Name of Entry SuperAsor(print) Name of authorized attendant(s) checked Entry Supervisor/Attendant or Entrant Contlned space preparation '. lires.rcl_a,rc veers to b2 diAewnwea and blan Ked oil.loi s 1.0 wx wtlw*t a ;oUllifir all twnkb ralve8.!05e11 and,ricked. ;;caw'gwitones Imkerd off. otherwise,eie:trtral sw.bnes taggeo ofF. !de,ror cc.-sa a-,cn acnievec by dirconnnchng Irnkaglll;n:•amrrr In.nave^?lls or Cnalns.othermse,equipment witlt rnee},anlwl parts.bltickerd to orevent rutaoon. ❑ .. .....rg Om Out6itle of Confined soarx as much as pc.s.o!e ce'ore enter-ng. rex space vertex.v..❑lowers-ail avaiiabin vnnnlannn oWre:.ng w Expected hazards ❑ 3urrur.„,wewinc I,,”ng er soork.orccucng operations ptorn^c doss -ac a nr work n?fmR h?en Obt?metl'r ❑ Yeb ❑ No Toxic .errosive r.•;.mmablr.rrawrlaiB ere Dre"Itt of used I,, woct?u n&._ TOxic atMOSphilve rosy develop due to work procedures.dr.-wronon from valir.ovanomwn or resinual Chelrnzis.or mitur?of Conhneri space: I.ow oxygen COncnm rrfabrin ey be oreeelrtt of produced during entry. Employee Qualifications i Name of authorized entrants Date SS Trained ❑ I All rlt Dlpy?e6 required to enter must have current(annual Confined Space C.,ol SOndbv entpiti^aa current Confined Soace Card. ❑ Number Of persons lirrnted in abndlute minimum. i ^tanbnP0 Out%lo6 wnere heisne can see wll activity.n tank.no joa duties ea'�.tu.ru mileh Oad turn location. I I I ❑ _tnndbyirmnrd m inxr?rdlCPR: Otherwise Medical cr Fire Department:meted of :ntry. I l ❑ tvrnrra tNrpnnn;.nosteq with erneweriov numbers and ir•:vucdbns. i Fire precautions I ❑ Foe extmpu.her i—eciamiy available t?ype A R t::) Stark resistant toolz rnv"Aln flarnm:.nl r �s•it ❑ Hot Wnrx Penr,t ❑ I F r O�•,.• f rrr,ved• ❑ Sou.k resistant tbtlls provided if flammaolc orr:.ent i Monitorin results j Toxicity Atmospheric testing LEL% ppm or m 'm' ' An momtcr octamou.r Pa verde In good working order. !3sto£e entry Al,n.urtdur is within curer calibration. Curing e. ^ rl eu mnnnnr.�m c..n nw.•_.��-nnr1 t�0.^._.^.=::'L'!�_'..��n....r... a_t ... . ... .... t)r rCTUICIV pdsld7nCd. Empicyrr.msvuz na ro Axit confined SDUe Ilrmedi3tely when ao"rounds. Personal protective equipment (Check Requirement) ❑ Hard hitt ❑Respirator ❑Hard hat Fier shmlcl ❑Ad-one reswrator ❑ FSC❑Shield ❑ ru9gleS ❑SCaA ❑ Goggles Ci Heonng Promcrron Q - ©Hearing proteeo0n ❑ t%th?r ❑Other ❑ nther jRescue and emergency '❑ tnlergency 5C`A equipment on hand and ready for rmmnmarr usa by I ❑ All envanr wear narnrza and cnnnnuany atrarnCn m nreun?. standby (Unld-r.retrnwal rquipmnnr would mrrnar e nwrAn ncK or entry or r I _ would hot COntrlbUt?to the rrtwuu of the entrant) l_I ALunobv andem:ane:methods o£emergency alwr to otnar H??Cn Untt 3 ❑ Pre-entry safety meeting held emploverz brirtm on mcalwe Fire Deeurtment �r V4CdurC�. Authorizatlon Signature(required before entry( __..._,......— :;lgnature.of entry iUD?NISOr' .J:.tc Time Time I 4ignatlrr?of antnof2?(1?,It,6nl :)Z:c 481-j9S