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APPENDIX B- PERSONAL PROTECTIVE EQUIPMENT (PPE) <br /> APPENDIX C-Pre-Entry Checklist <br /> Date Completed ,1, 1'7 Time Completed <br /> Space Description. STV Service Station No. <br /> Equipment Affected <br /> Team Members S' ` <br /> Work Description <br /> Pre-Entry Immediately After After Mechanical Any Additional <br /> Atmospheric Manhole Cover has Ventilation has been Testing <br /> Checks been Removed added <br /> Time(am-pm) <br /> Oxygen(19.5%-23.5%) -cam77 <br /> Explosive(<2%LEL) <br /> Toxic(PPM) <br /> Testers Signature <br /> Testing Equipment Calibration Date , <br /> Pre-entry Fluid Yes v No N/A If No or N/A, why? <br /> System Isolation <br /> Pumps/lines valve closed, <br /> or electrically disconnected <br /> Yolk Disconnected <br /> Ventilation Source Yes No N/A If No or N/A, why? <br /> Established <br /> Mechanical Forced Air <br /> Natural Ventilation <br /> Reasoning for <br /> entilation Choice <br /> Communication Procedures for Other Affected Workers or Site Supervision <br /> PERSONAL PROTECTIVE EQUIPMENT (PPE) <br /> When a hazardous situation is recognized, steps should be immediately taken to eliminate the hazard either by engineering revision or by <br /> changing work methods. If it is not practical to eliminate the hazard,then personal protective equipment(PPE)must be used. <br /> PPE Requirements <br /> 1. High visibility vest: Always <br /> 2. Glasses,goggles or face shield: Always <br /> 3. Ear plugs or muffs: When working in close proximity to loud noises(jack hammer,vacuum trucks) <br /> 4. Hard hat: When overhead hazards exist <br /> 5. Safety Harness&lifeline: When working in confined spaces in depths greater than 5 feet <br /> 6. Gloves(chemical resistant): When working with gasoline or other solvents or corrosive chemicals <br /> 7. Gloves(leather or cotton): When working with sharp or abrasive materials <br /> 8. Long pants and work shirt: Always <br /> 9. Boots or shoes(leather): Always(Note:Steel toe safety shoes may be required for certain operations) <br /> 10. Respiratory Protection: As needed for protection against specific hazardous atmosphere <br /> Control Status: Controlled Revision Date: August 29,2004» 5 <br /> DADCD i f-1DICC ADC 1 IK6f'nAITD^1 I CM TUIC r nDV 1/AI 111 r%kII V AT TUC TI11AC r1C DDI/.ITI/.IP` <br />