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



PDF Version






____Oxygen content


____Combustible dust, visual


____Toxic gas measurement



____Nearby workers

____Air Supply

____Rescue team

____Inert atmosphere

____Signs, posting

                Physical Hazards

                           Personal Protective Equipment



____Life line, lanyard



____Retrieval line, harness, wristlet

____Tripping hazards

____Hard hat

____Communication system(s)

____Caustics or acids



____Temperature extremes



____High pressure

____Hearing protection

____Buddy system

____Animals, insects, plants

____Face shield

____Secure all materials

____ Limited/obstructed entry


____Other (specify)







___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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