Safety
Confined space entry permit
A permit-required confined space entry permit with every item OSHA 1910.146(f) asks for: the space, purpose, people, hazards, isolation, atmospheric tests, rescue and sign-off.
- How often
- Each entry
- Who
- Entry supervisor
- Time
- About 15 min
- Items
- 22
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Before you use it
- Under OSHA 29 CFR 1910.146(e), the entry supervisor signs the permit before entry begins, it is posted at the entry portal or otherwise made available to the entrants, and it lasts no longer than the job needs.
- The entry supervisor cancels the permit when the work is done, or when a condition the permit does not allow arises. Keep cancelled permits for at least a year, with any problems noted on them.
- This template follows the items listed in 1910.146(f). Fill in your program’s acceptable entry conditions and test order; it does not replace your written permit-space program.
Space and purpose
- 1Checkpoint scan
Scan the space’s tag
- 2Note
Permit space to be entered
- 3Note
Purpose of the entry
- 4Note
Date and authorized duration
People
- 5Note
Authorized entrants, or the roster used to track them
- 6Note
Attendants, by name
- 7Note
Entry supervisor, by name
Hazards and controls
- 8Note
Hazards of the space
- 9Note
Isolation and controls: lockout, purging, inerting, ventilating, flushing
- 10Note
Acceptable entry conditions
Atmospheric tests
- 11Reading· %
Oxygen
OSHA counts below 19.5% or above 23.5% as a hazardous atmosphere.
- 12Reading· % LEL
Flammable gases and vapors
OSHA counts more than 10% of the lower flammable limit as a hazardous atmosphere.
- 13Reading· ppm
Toxic gases
Test for the substances your hazard assessment names, against their exposure limits.
- 14Note
Tester’s initials and time of each test
- 15Note
Periodic test results, with times and initials
Rescue, communication and equipment
- 16Note
Rescue and emergency services, and how to summon them
- 17Note
How entrants and attendants stay in contact
- 18Note
Equipment: PPE, testing, communications, alarms, rescue
- 19Note
Other permits issued, such as hot work
Authorization and close-out
- 20Signature
Entry supervisor authorizing entry
- 21Choice
Permit cancelled because
Work complete · A condition the permit does not allow
- 22Note
Problems encountered during the entry
Download this checklist
Free, no sign-up
Field types in this template
- Checkpoint scan
- Note
- Reading
- Signature
- Choice
In Vardian, readings are checked against their limits as they are entered, and photos and signatures attach to the check itself.
From the sheet to the round
Build a template as a Vardian form, and each line becomes a checkpoint that knows its limit.
Animation: a paper checklist line, compressor discharge pressure with a blank for the reading in bar, becomes a Vardian checkpoint with a limit of 7.0 to 8.5 bar. Scanning the compressor's NFC tag verifies the checkpoint, a reading of 9.1 bar is flagged out of range, and a work order is created from it.
Run this checklist on the round
We'll set it up in Vardian with your checkpoints and limits during a demo.