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Confined Space Entry Permit (1)
Confined Space Entry Permit (1)
Date:
Tank #:
Attendant:
Work to be performed
HAZARDS
- Space may contain low levels of oxygen (U2) / high levels of carbon dioxid e (LU2)
- P O T E N T IA L L Y H A Z A R D O U S A T M O S P HE RE M U S T BE TESTED A N D R E C O R D ED ON PE RM IT PRI OR TO E N T R Y
- Symptoms of CO2 toxicity include; dizzi ness, hea dache, nausea, vomiting, rapid breathing/heart i ate,
confusion, loss of consciousness, death
- Engulfment
- Slips, trips, and falls
Required Equipment
Before Entry:
7,O2
IF 02 ALARM GOES OFF AT ANY TIM E
ENTRANT MUST LEAVE THE SPACE
IMMEDIATELY!!!
1S min:
%02
3
0
m
i
n
: