COMPLIANCE INFO_1996-1999 - Laserfiche WebLink

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FEB 05 '99 14:41 FR CONTAINMENT SOLUTIONS814 542 5020 TO 9-15108958426 P.05/20 ,,ENTRY PERMIT FOR PERMIT REQUIRED SPACES Location: Description of confined area: Permit number: Permit date: Description of work: Time issued: Time expired: Required if ENTRY CHECKLIST: to be completed by Name of Entry Supervisor(print) Name of authorized attendant(s) checked Entry Supervisor/Attendant or Entrant Confined space preparation Gl all linea inciuemp veots to be discotmeated and blanked off ciase a:ink wneneve po%sibie.all tanks valves closed and lacked. All electrical power swr._nes lockea atf- arnerwor t.electrical!~tcnrs Tagged art ❑ iscnsuVicel isolation aChreved by disconneeCtitiftU Gnkagei Or rrrttovinq dtrM.belts or chains,ottierwlte,riruiptnenlwith rtuti0riniusi parts bkk:krd to prevent imViOn. M Cleaning will bel prrfcmea?rem out Lida of cAtttmed rpor e ae mete.as poswie be"9Menng,or pumped tree of liquid motan9l to Date Inti or trax ar wnian Minn thn gpacc may . be-entered to remove solids. Confined space vented math domrs.•all avoilzb1c:veMilaton ope-atmg. Expected hazards -t Morninr w61d permit ;,� J, 'n9.tva4nR,ur iv;+tk•prt7ducinA opmrarians Planned. 'r yr TJS a hat ware been a tainedl V PM - ❑ Toxic.conative,or itarnmable materiah are presrrn or used in work procedum'_ ❑ t er an atmosphere may develop Cue to work Ofoeredurea,d"orabor horn wails,evaporation Of residual ahemica w of nature of confmrd%traces ❑ Low oxygen concentration may be present or produced during Mire. _ _. . J:rnployeelivaGfications•--._.._.�.. _.___ --_,�_ Name of authorized entrants Date SSN Trained ❑ ria rimployee^.nstuurd In enter must nave current(annual confined Smer Cald. ❑ Standby empicyce not:Warrent Confined Space Card. ❑ Number of persons limited in absolute minimum. ❑ standby stationed outstdd where halsne can:de ail activity in tank;ne job dataea asrJgnrd w tttGn can from locAQOn. ... ❑ .Standby trained in fir=sidrCPR: otherwise Mrdu:f or Fim Gopem"it elarted of WWI. ❑ Nearest telephones pc ted with emergency numbers and inntr than% Fire precautions m texanguisher tmmsdiately available. (Type A 0 C) ❑ SpeAt resistant t"6 provided d aammablr present.i-t U Fktt Wank permit repuimd ❑ Spark tesiatatn triols pines a tlammatlta pr.rs'tnt . Mondori results Toxicity AtmwspheriC testing OZ 1. LEI..% ppm of tat ❑ Air monitor ooainco,and varifice in goira working order aefore Ientry ❑ A,r nnonlror is within current calibrition. Ounng mu C) Air monitor wom and ararramtg continuously on one WWKer In Bach entry or remotely Positioned. ❑ einployee instructed to exit confined space immediately when alarm ao a ft. Personal protective equipment (Check Requiremenq r—r r7 Fkard two ❑Respirator ❑Hard hat ❑ Farn Shield ❑AN-line Monitor ❑ FaCrr ShWW . ❑ Mnga" ❑=RA ❑ anggles 0 l louring Prolechan ❑ ❑Hearing aroteetian ❑ pm.+, ❑war Dater Rescue and emergency ❑ tmargoncy SCSA eQu imam on harm and ready for nd immediate nw by ❑ An entrants wear name"aa�nrnuauy att#,ned to matins. standby. (unless removal iximma nt would rocrease owewall risk of entry or would net wntribute to the re-.cur of the enuanu Q standby unoerstanas madtarlw of e-margency pkat to othw Me vlth Una 3 ❑ pre-envy salary meeting herd amou"as bridled on rescue Ftrr department procedures. Authorization Si nature r uired before en Signatum orentry supitimAor Date rime Signature of adandant Date Tithe R Signature of authumt-d rntrant Date I Time 473•j99