ConfinedSpaceAssessments.docVIP

Confined Space Assessments For Henrita Academic Building Page # Confined Space Location 2 AHU #9 (Mech. Rm off Rm 09) 9 Elevator Pit 3 Pipe Closet in Room 09 5 Tunnel Access 1 in E Mech. Rm 7 Tunnel Access 1 in Large Mech Rm 6 Tunnel Access 2 in E Mech. Rm 8 Tunnel Access 2 in Large Mech Rm 4 Tunnel Access in Hall (lower level) CONFINED SPACE ASSESSMENT Decision: Permit Required Non-Permit Building: Henrita Academic Building Confined Space Location: AHU #9 (Mech. Rm off Rm 09) Date of Assessment: May 6, 2003 Conducted By: Purpose of Entry: Repair and maintenance NO. 1 To determine if the space listed above is a confined space, highlight the response that best applies to the space being evaluated.The space is large enough and is so configured that an employee can bodily enter and perform assigned work.  YES NOThe space has limited or restricted means of entry or exit. (i.e. tanks, vaults, vessels, silos, storage bins, hoppers, pits, diked areas) YES NOThe space is not designed for continuous employee occupancy. YES NOIf ALL three of the above statements were answered YES, the area being evaluated is a CONFINED SPACE. Continue to the next section to determine if it is a “PERMIT-REQUIRED” confined space. If ANY of the above statements were answered NO, check the following box and proceed no further. The area does not qualify as a “confined space.” NO. 2 Use the following section to determine if it is a “permit-required” confined space. The space contains, or has the potential to contain a “hazardous atmosphere”. Check all those that apply.  YES NO ______ Flammable gas / vapor / mist Fuel supply locked out/disconnected  _____ Oxygen conc. below 19.5% or above 23.5%  _____ Airborne combustible dust conc. or = its LFL. Dust obscures vision @ 5 feet or less.  _____ Atmospheric concentration exceeding the PEL or dose for any substance published in subpa