**Job Hazard Analysis for**

**Confined Space**

**Contractor Name:**
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** **Date:**
**\_\_\_\_\_\_\_\_\_\_\_\_**

Name of confined space:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Space Location:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Is It a Confined Space?**

1.  Existing ventilation is insufficient to remove dangerous air
    contamination oxygen enrichment and/or oxygen deficiency which may
    exist or develop.

Yes No

Description:

2.  Ready access or egress for removal of a suddenly disabled employee
    is difficult due to the location

and/or size of the opening(s).

. Yes No

Description:

**Is It a Permit Required Confined Space?**

1\. Contains or has the potential to contain a hazardous atmosphere;

Yes No

Description:

2\. Or a material that has the potential for engulfing the entrant;

Yes No

Description:

3.  Has an internal configuration such that an entrant could be trapped
    or asphyxiated by

inwardly converging walls or by a floor which slopes

Yes No

Description:

4\. Contains any other recognized serious safety or health hazard.

Yes No

Description:

**Safety Hazards**

Animals or insects (stinging, biting, snakes, skunks)

Low ceilings (ergonomics, sharp objects, visual obstructions)

Sharp Objects

Electrical hazards (live circuits, metal ropes around electrical
devices)

Mechanical hazards (rotating belts, blades, gears, pinch points, etc.)

Adverse temperatures (steam lines, coolant lines)

Slippery ladder rungs

Rusty surfaces (cuts, hides chemicals, poor footing)

**Job Hazard Analysis for Confined Space**

Chemical coated walls/surfaces

Biological residue / slime (exposure, slippery surfaces, sewage)

Loud ambient noise from traffic, etc. (annoyance, communications
interference)

Vibration (discomfort, noise)

Poor lighting (can't read meters, can't perform critical tasks)

Radiation

Extreme ergonomic conditions including those that may occur because of
PPE limitations;

respirators, fall protection harnesses, connection to retrieval
equipment; low ceilings.

Liquids on floors / walking surfaces (standing water)

Hazards external to the space that could affect operations (combustion
exhaust, precipitation,

vehicle traffic, overhead electrical wires, chemical / hazardous
materials lines nearby)

Others

**Health Hazards**

1\. Chemical Hazards

MSDS available?

Yes No

2\. Asphyxiation Potential:

Yes No

**Getting to the Confined Space**

Entrance easily accessible

Yes No

Ladder, scaffold required?

Yes No

Describe entrance, including size and location of portal:

Enough space available to set up all equipment at entrance? Yes No

Type of entry: Vertical Horizontal

**Internal Configuration**

 Low ceilings-how low?

Can a person: Walk in Erect Stooped

Crawl in Hands & Knees Stomach / Back

Footing conditions inside space:

-   Flat surface

-   Cramped

-   Round (horizontal duct)

-   Uneven surface

-   Slippery footing

-   Obstructions that have to be stepped over

-   Sharp objects

-   Spilled chemicals

-   Other:

-   Structural Cross-Members

    1.  Low ceiling

    2.  Head hazards

    3.  Climb over required

 Has a configuration that will prevent adequate purging.

**Job Hazard Analysis for Confined Space**

**Engulfment Hazards**

-   Liquid

 Water always present  Usual depth  Potential depth

-   Powder / grains

-   Sludge, Sewage

**Fall Potential**

-   How far?

-   Fall directly onto concrete / level surface

-   Fall onto something sharp?

-   Any place to tie-off / secure lanyard or winch

-   Extraction device available?

**Entry Conditions**

Vertical Entries

-   Stairs in place?

-   Industrial stairs?

-   Ships ladders?

```{=html}
<!-- -->
```
-   Fixed ladders?

-   Straight portable ladders?

    -   Condition of ladders?

    -   Tripod accessible?

    -   Even surface, tripod okay? Not okay? Describe:

    -   Uneven surfaces, tripod not okay? Describe:

    -   Tripod available has chain on legs, or not?

    -   Tripod unusable due to inability to place legs, cylindrical
        surface?

    -   Requires other method

    -   Secure to overhead beam? (Beam structurally Okay)

    -   Need eccentrically support or davit?

Horizontal Entries

-   Elevation above ground?

-   Work platform provided to upper elevation?

-   Place to secure lifeline?

-   Location to place mechanical device?

-   Abrasion hazards can damage rope?

**Entrance / Exit Configuration**

-   Opening? Type:  Round, Oval, Square, other

> What diameter / size?

-   Vertical? How Far?\_\_\_\_\_\_

-   Horizontal? How Far?\_\_\_\_\_\_

**Internal Features**

-   Pipes with mechanical joints or possible openings inside space?

-   Materials in pipes / lines?

-   Electrical equipment that needs servicing?

**Job Hazard Analysis for Confined Space**

-   Possibility of engulfment?

-   Entrapping features (converging walls, wedging situations)

-   Pipe / lines going through the space?

-   Any mechanical joints (flanges, valves)

**Contaminants To Sample For**

-   Oxygen

-   Combustible gases? Type:

-   Toxics type:

-   Direct reading instrument available? Type:

-   Use colorimetric?

**Known Use of Space**

-   Originally

-   Present use

-   Contained chemicals

-   Oxygen consumers? Rust, decay, wet carbon, chemical reactions,
    combustion

**Hazards / Features of Surrounding Areas**

-   Piping or chemical containers?

    1.  What chemicals?

-   How far away?

-   Possibility of spill into confined space?

-   High noise levels? (Communications interference)

-   Soil methane present?

-   Parking lot , loading area or parking spaces close by?

-   Can anything fall into hole?

-   Poor lighting in area?

-   No electrical services?

-   No ground point?

-   Traffic hazards? (in surrounding area)

**Seasonal Weather Effects**

-   Must the entry be made in bad weather?

-   Precipitation could create hazards, e.g., subject to rapid flooding?

**Other**

-   High ambient noise (or anything that can hamper communications)

-   Ambient temperature extremes (heat stress, direct sun exposure, cold
    stress, ice formation, on

working surface?

-   Poor lighting

**Intended Activities, Hazardous energy hazards**

-   Moving machinery hazards Written Lockout procedures in place?

-   Electrical energy hazards? Written Lockout procedures in place?

-   Lockout points identified?

    1.  Tagged / labeled?

    2.  Described in procedures?

-   Chemical hazards line breaking required?

1.  Identified shutoff valve

2.  Line blanking required

**Job Hazard Analysis for Confined Space**

**Site support Features**

-   Certified grounding point available or in proximity?

-   Electrical services present

1.  How many outlets? (two separate circuits recommended)

2.  Generator required?

-   Telephone nearby?

```{=html}
<!-- -->
```
-   Rope anchorage points available for rescue?

-   Other

**Equipment**

Type of equipment needed to enter / exit space?

-   Portable ladders

**Visual**

-   Poor lighting

-   Entrants cannot be visually observed by the Attendant

**Ventilation**

-   Space has configuration that will hamper effective ventilation /
    purging?

    1.  Convoluted space

    2.  Large volume

    3.  Second or additional opening

        -   Exits close together

        -   Favors flow through ventilation

        -   Distance between openings

        -   Estimate of spare's internal volume

**Communications**

-   Internal available

-   Radio required

-   Voice only adequate

-   Intrinsic safety design required

-   Radio interference

    1.  Inside space

    2.  Outside space

**Distance In**

-   Greater than 50 feet? (Greater than the length of the extrication
    cable)

-   Will require extra internal attendant(s)?

**Sewer / Manhole Work**

-   Telecommunications / Electrical

-   Sewer

    1.  Sanitary?

    2.  Storm?

    3.  Combined?

**What industry**

-   General industry

-   Telecommunications

-   Electrical utility work in vaults

-   Construction