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Rescue Procedures <br /> Training Verification <br /> The following persons successfully completed required training and training is current for the space to be entered <br /> Position YES NO <br /> All persons entering Confined Space <br /> All persons acting as Supervisor for the Entry 154 <br /> All persons assigned to monitor access and interior activities '. <br /> All persons assigned to emergency rescue team <br /> Entry&Rescue Equipment on Scene <br /> Description Type YES NO NAI Description I Type YES NO NA <br /> Safety Hamess/life line PPE&Protective Clothing <br /> Fall Arrest/Hoisting equip y Communication equip % <br /> Supplied Air Respirators 5,Cj Fire Extinguishers <br /> Confined Space Entry Permit Page 2 <br /> Note: Within a confined space, hand tools should be of a non-sparking type, electrical equipment should be <br /> intrinsically safe or explosion proof, and battery-powered equipment should be low voltage. <br /> Approval: A review of the work authorized by this permit and the inf ation contained on this Entry Permit, as <br /> well as written instructions and safety procedures have been commu c ted to all affected personnel. Entry <br /> cannot be approved if any items are marked in the "No"column. <br /> This permit is not valid unless all appropriate items are completed. <br /> Permit Prepared and approved by: (Entry Su er r) <br /> (Printed name) (Sig ture) <br /> This permit is to be kept at the jobsite throughout the job. <br /> Upon completion, forward the completed permit with the job tickets and verification forms. <br /> Control Status: Controlled Revision Date: August 29,2004» 7 <br /> PADCO r`nDWIZ APC I INr`nNTPnI I Fn TRIC r'nov wai in nNI v aT TN9=Tllm=nC PPIIJTIAI(_ <br />