Exhibit 2, 242 FW 11, Confined Space Entry Checklist, Fish and Wildlife Service Manual, U.S. Fish and Wildlife Service

Exhibit 2, 242 FW 11
Confined Space Entry Checklist

Supersedes 242 FW 11, FWM 273, 09/30/96

Date: November 13, 2007

Series: Occupational Safety and Health

Part 242: Industrial Hygiene

Originating Office: Division of Safety and Health

HAZARDOUS ATMOSPHERES VENTILATION			INFORMATION/TRAINING
____Flammability			____Attendant
____Oxygen content			____Entrants
____Combustible dust, visual			____Supervisor
____Toxic gas measurement			____Contractors
____Exhaust			____Nearby workers
____Air Supply			____Rescue team
____Inert atmosphere			____Signs, posting
Physical Hazards		Personal Protective Equipment
____Electrical		____Respirator		____Life line, lanyard
____Mechanical		____Glasses/goggles		____Retrieval line, harness, wristlet
____Tripping hazards		____Hard hat		____Communication system(s)
____Caustics or acids		____Gloves		____Lighting
____Temperature extremes		____Clothing		____Attendant
____High pressure		____Hearing protection		____Buddy system
____Animals, insects, plants		____Face shield		____Secure all materials
____ Limited/obstructed entry points		____Other (specify)
Isolation
___Lockout/tagout	___Blinding/blanking*				___Disconnect
___Barricades
___Rescue service contacted

Completed By: ________________________________ Date/Time Completed: _______________________

Location Completed for: ________________________________________________________________________

[*] Blind blanking means inserting a solid barrier across the open end of a pipe leading into or out of a confined space, and securing the barrier so that nothing leaks into the confined space.

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