Laserfiche WebLink
- , l 1, Cis- t; , w� , =s t ,1 7 -t i :♦ '` <br /> tRICKSON: INC. ERICKS0111,' II�C. <br /> CONFINED SPACE ENTRY PERMIT P'RE-EF ='RY RQUIRMENTS '.r yl ii <br /> NO TANK OR CONFINED SPACE MAY 89 ENTERED UNTIL THIS PERMIT-HAS BEEN• r ',BEFORE THIS PERMITMAY RESIGNED,FHEVOLLOWINGMUSTBE pomp <br /> LETE$ �. <br /> r I F CHECKED NO,EXPLAIN ON NO:B B t <br /> COMPLETED,CHECKF,D,'AND SIGNED. :� ' <br /> LOCATION �! G� C 1�1q vr'� y DATE: (GOOD FOR THIS DATE ONLY) <br /> J 1 ( •' ' ' ' Y VES �DIO <br /> :St�'CKTO,ti CAL <br /> ��.." 1;• r• - - _ "L'/A^L LINES DISCONNECTED OR BLINDED? �. _-. •,.� r <br /> I i <br /> JONUMBER 9 - a ' <br /> B <br /> 2. ALL EMPLOYEES TRA WED IN CONFINED SPACE WRYj <br /> TANK NO,CR DESCRIPTION TIME - <br /> t7 / .3 'PHVSICAL/CHEMICAL HAZARDS INSPEO LIl k <br /> .1 1 <br /> •� - -- 1 ORYGEN CONTENT CHECKEb/7-- ' • ' ? .Q <br /> - .. <br /> WORK TO BE DONEE: �I y�• - - - $bXVGENDATE IE7�^L TBdE * r ►. :i•'„y <br /> C� � �• e< <ot SC FLAMMABLEJEXPLOSIVE VAPOFISCHECKED7 . ® ' .(� •y;] <br /> `-T•1 1 <br /> I-;CONCEKTRATIOM4-LLL_�/�TE TIM{€LJr'I!-1 y , <br /> SPECIAL PRECAUTIONS/PROTECTIVE EQUIPMENTREQUIRED: � ! - -- •;. � <br /> HARD HAT;SAFETY GLASSES,LONG SLEEVES # _ k P[i TECT)VE,EOUIPMENT.CHECKEbj <br /> O•IHER: FLAk� CO. .cr..�cr A7Soo-3�CarTv'����5 f <br /> 7! Hy�IDE!$IANDBIPPERSONNF,IASSIGNEDJ�. •� • <br /> ct <br /> e-S� l.�lns jv�l.lwb`o¢� �wiL r 7� <br /> IF FRESH AIR IS RUbl%ED,NO,1 AiG4DBY MUST HAVE AN INDEPENDENT AIA `�. STARD�`f°NO.1` STANpBy ,2' - •• . �w;R ! <br /> SUPPLv�gre �Cp i��(' c} , t.� - - ••� - >. - <br /> 1 SAf ETY Hg11NES5/LIFELINE WOR ALL <br /> .PERSONNEL?. �- F <br /> ICE RTIFY THE'ACCURACY OF-THIS PERMIT AND THAT ALL_PRE-ENTRY REQUIRE- -r�, 'r a <br /> MENT$( N T}fE BEV FRSE SIDE HAVE BEEN.QONIPLETED, ° - - • -' '�^+,• <br /> - --9. SPECIAL CONISIDERATIONS7EX TLOflS �L'•. r • `+• ,. <br /> . • 1 #` .r <br /> THIS PER <br /> • �!sr <br /> IIXIT MAY NOT BE SIGNED UNLESS ALL PRE-ENTRY REQUIREMENTS ARE 1 - Q��% i fij • ' `ry fj. < ? <br /> ¢HECK;ED'YES'OR EXPLAINED, .•.�, _ _ >, - �p r r .rw <br /> y r01"e,Y.,.,•0.,n r - - - - aq-.<�", + !.,j41,t PfiHSONNEL MSIST REIJkLkTH1SPERMITBEFORi ENT+FOiK•�." <br /> TITLE S NEE) ,- _ DATE—� -,-€iETURN TA($PERMIt TZ YOUR SUPERYISO(i-L�ON JS1fi 601N�I,ET10N <br /> w _. <br /> Y, �• � ,� <br />• THIS PERMIT MUST BE POSTED ATA jI(utES WHILE WORD IS IN PROGRESS, � EMERGENCY PHONE NUMBERS: <br /> _ • . �1 - •'. ERICKSON,INC� <br /> LbCALFIREIIEPANTMENTL <br /> •LOC � <br /> AL H09WVAL/AMQULgNC �_ . _ <br />