Confined Space Entry Permit

1Space identification & classification — 29 CFR 1910.146(f)(1)–(3)

Space name / identifier

Space location

Space type

2Atmospheric testing — mandatory sequence: O₂ → LEL → toxic — 29 CFR 1910.146(f)(5),(d)(5)

⚠ Critical: Always test in this order — oxygen first, then flammable, then toxic

Oxygen (O₂) first — if O₂ is deficient, the LEL sensor gives false low readings. Must confirm O₂ safe range (19.5–23.5%) before proceeding.
Flammable gas / LEL second — if LEL ≥10%, immediate evacuation. Do not test for toxic gases in a potentially explosive atmosphere.
Toxic contaminants last — only after O₂ and LEL confirm safe. Test all relevant contaminants for this specific space.

Parameter	Acceptable limit	IDLH / action	Result
1. Oxygen (O₂) Test FIRST — always	19.5% – 23.5%	<16%: rapid impairment >23.5%: fire hazard	—
2. Flammable gas / LEL Test SECOND	<10% LEL (OSHA limit)	≥10% LEL: stop entry ≥25% LEL: evacuate	—
3. Carbon monoxide (CO) Common combustion product	≤25 ppm (OSHA AL)	IDLH: 1,200 ppm PEL: 50 ppm TWA	—
4. Hydrogen sulfide (H₂S) Sewers, manholes, refineries	≤1 ppm (NIOSH REL)	IDLH: 100 ppm Olfactory loss: ~100ppm	—
			N/A

Instrument used

Instrument serial / ID number

Last calibration date

Tested by (name, competent person)

⚠ Instruments must be bump-tested or calibrated before each use. Testing must be conducted from outside the space before entry and at all levels (top, middle, bottom) of the space where stratification may occur.

Reference: OSHA acceptable atmospheric limits for entry — 29 CFR 1910.146(b)

Oxygen: 19.5%–23.5%Below 19.5% = oxygen-deficient. Above 23.5% = oxygen-enriched (fire hazard).

Flammable gas: <10% LELOSHA PRCS limit. >10% LEL = prohibit entry. >25% LEL = evacuate immediately.

Toxic substance: <50% IDLHConcentration must be below 50% of the IDLH for each identified contaminant.

3Isolation — lockout/tagout & purge confirmation — 29 CFR 1910.146(f)(10)

All hazardous energy sources (electrical, mechanical, pneumatic, hydraulic, chemical, gravitational) feeding into or associated with the permit space must be isolated and locked out before entry. List each isolation point below. Ref: OSHA 29 CFR 1910.147 · 1910.146(d)(3)

Energy source / line	Isolation device / valve	Energy type	Method	Isolated by (name)	Lock tag no.	Verified ✓

Purge / inerting method (if applicable)

Ventilation provided

4Equipment, PPE & rescue provisions — 29 CFR 1910.146(f)(8),(9)

Respiratory protection type

Emergency rescue service / contact

Rescue response time

5Authorised personnel — signatures required before entry — 29 CFR 1910.146(f)(6),(7)

All personnel must sign this permit before entry begins. The Attendant must remain outside at all times and may not enter for any reason unless relieved by another qualified Attendant. Ref: 29 CFR 1910.146(i)

Role	Name (print)	Training current? Date	Signature	Time in / out
Entry Supervisor Authorises entry · Cancels permit
Attendant Outside at all times · Never enters
Entrant 1
Entrant 2
Entrant 3

6Pre-entry safety briefing checklist — 29 CFR 1910.146(g)(1)

The entry supervisor must brief ALL entrants and the attendant on the following before any entry begins. All items must be checked before entry is authorised.

Hazards specific to this space reviewed with all entrants and attendant

Emergency procedures and rescue plan reviewed — all personnel know evacuation signal

All atmospheric test results reviewed — all readings within acceptable limits

Isolation (LOTO) confirmed complete — all energy sources locked out and verified zero energy

All required PPE fitted and inspected — harness connected to retrieval line

Communication system tested — entrants and attendant confirmed in contact

Attendant confirmed stationed at entry point — will not leave for any reason

Conditions that require immediate evacuation reviewed with all entrants

Hot work permit issued if any hot work planned inside the space

Continuous atmospheric monitoring confirmed active with audible alarm

7Permit authorisation — 29 CFR 1910.146(f)(15)

Entry Supervisor Authorisation

I confirm that all conditions specified in this permit have been satisfied, the space has been tested, all personnel have been briefed, all equipment is in place and functional, and entry is authorised for the work scope listed above. This permit is valid only as specified above.

Entry supervisor name

Signature

Time authorised

⛔ Permit cancellation — complete if entry is cancelled or conditions change

Cancel this permit immediately if: atmospheric conditions change, an uncontrolled hazard appears, a worker is injured or becomes ill inside, the scope of work changes, or the permit expires. All entrants must exit the space before permit is cancelled.

Cancelled by

Reason for cancellation

Time cancelled

Additional notes / special conditions / deviations