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FEB 05 99 14:45 FR CONTAINMENT SOLUTI 14.542 '5020 TO-9-15108958426 P:14/20 <br /> 4rENTRY PERMIT <br /> FOR RMIT-REQUIRED;SPACES <br /> Location: Description of confined area: Permit number: Permit date: <br /> Description of work: Time issued: Time expired: <br /> Required if ENTRY CHECKLIST: to be completed by Name of Entry Supervisor(print) Name of authorized attendant(s) <br /> checked Entry Supervisor/Attendant or Entrant <br /> Confined space preparation <br /> ® All lines including vents to ba diccpnnsk tad and blanked Ott Copse to tank wheneve poerible.all tanke valves closed and kicked. <br /> All rlr.C.1nCAI power Switchrb locked off. otherwise,electrical switches togged off. <br /> © Mechanical isolation achieved by disconnecting linkages or removing nerve oerts or chains;othenMse,equipmeht with mechanlual pans blushed to prevent wtatiun. <br /> Onamng will he performed from outside of confined space as much as pess ble before entering. <br /> ❑ Confined space vented with blowers:all available,vrntilatinn operating <br /> Expected hazards <br /> ❑ Butning,welding,bruing,or spark.producing operations piannrd If}ms.;lax a by worx permit been obtained*! ❑ Yes ❑No <br /> Toxic.corronive,or flammable.materials are present of used In work Croceuuie:_ <br /> Toxic atmosphere may develop due to work procedures,do-sorption from walla,nvoporatlon of rg51du91 chemicals,Of nature of confined space: <br /> ® Low oxygen concontrahnn may be pf9eent of produced during entry. <br /> Employee qualifications Name of allthadzed entrants Date SSN <br /> Trained <br /> ❑ Aa Cmptoyees required to enter must have current(annual Confined Space Card <br /> ❑ Standby employer has current Confined Space Card. <br /> ❑ Ntembor of parsons United in absolute mininwm. <br /> ri :Standby stationcO outside where he/she Cam See all aotivity in tank.no job duties <br /> eaettvted wtdch call(turn location. <br /> ❑ Standby trained in heat aid/(-,PR: otherwise Medical or Fire Department aicrtod of :nay. <br /> Cl Noam_s tairpnonCs posted with erriergency numbers and instructions. <br /> Fire precautions <br /> ❑ Fire extinguisher immediately available (Type A 8 av) ❑ Spark resistant toms pmvmetd d flammable p ".1t <br /> ❑ Hot work Nennit fetiulted. ❑ Spark resistant took.prow ted d tlammatue prc�cm <br /> Monitoring results <br /> Toxicity <br /> Atmospheric testing 0A LEL% `'porn or; <br /> /(fila <br /> ❑. Air monrmr otsainad,and vended In good worldng order. tjalPr9 <br /> entry <br /> ❑ Arfmunitutibwithincurenitalibration. During <br /> Orstry <br /> I—I Aa mnnitnr war n mnef new+orcin,-.,nll.o,n.,Jv nn.,..,.„w..4�.,w..e.k...,w.: - . <br /> ........__��._.....'_........_.._.r........_.._..._......�.. <br /> or remotely positioned. <br /> ❑ Employee instructed to axtt Wined space ihtmediately when alar sounds. <br /> Personal protective equipment <br /> (Check Requirement} <br /> ❑ Hail hat ❑f2tap{nnor ❑Hard hat <br /> ® face%(held 0 Air-me,moiratior ❑ Face Shield <br /> ❑ Cugglrs ❑SCBA ❑ Goggles <br /> ❑ Hearing Protraction ❑ ®Headng Protection <br /> ❑ me( ❑other ❑ Other <br /> Rescue and emergency <br /> ❑ tmergancy SC13A equipment on hand and ready for immadiatrt uaa by ❑ AR entrants wear harness and continually attachCd to ktehne. <br /> standby <br /> (Unit=rotrici al equipmnnt would nncrnaco overall r*k at entry or <br /> would hot contribute to the rrecue of the entruni) <br /> ❑ 5wndby undermands methods of emergency alert to boar Health Unit A ❑ pre-entry safety meeting held,employenr.bneted on rmaun <br /> Fite Depurtment. rocedumm. <br /> Authorization Signature(required before crit <br /> Signature of entry svpemsor Datr-. Time Signature of attendarn Cute Time <br /> i <br /> Signatta8 of ai thorizpd entrant Date Time <br /> 481499 ,1 <br />