Confined Space Entry Permit

Gsa 3625 pdf pdf 357 kb pdf versions of forms.

Confined space entry permit. Send a completed copy to ehsdept uw edu. Permit required confined space program permit space program means the employer s overall program for controlling and where appropriate for protecting employees from permit space hazards and for regulating employee entry into permit spaces. Sample confined space entry permits use with confined spaces book chapter 296 809 wac the following 3 fill in the blank confined space entry permits can be modified to fit your particular entry or used as they are if they can fit your entry needs.

Complete the top portion of the permit confined space entry form. See flow chart page 5. Employers in general industry must evaluate their workplaces to determine if spaces are permit spaces.

This is confined space permit template is in a multipage comprehensive permit provided in microsoft word. You re not required to use the fill in the blank entry permits provided here. Osha defines a permit required confined space as a confined space that meets one or more of the following characteristics.

Permit duration not more than one shift in hours uw confined space description location address confined space entry permit this permit must be posted at the job site until entry is complete. Contains or has the potential to contain a hazardous atmosphere contains a material that has the potential for engulfing an entrant. Permit must remain at entry point s until work is complete a copy must be forwarded to cspm within one week of entry maintain one copy of shop location only authorized entrants listed on.

Obtain a permit confined space entry form from program coordinator. Osha s standard for confined spaces 29 cfr 1910 146 contains the requirements for practices and procedures to protect employees in general industry from the hazards of entering permit spaces. You can also design your own entry permit.

Confined space entry permit. Confined space entry permit.