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Confined Space Entry Program (RMS-3, Rev. 2)CIT Y O F DE LRAY B EA C H EM PLOYEE SAFETY MANU A L DEPARTMENT: SUBJECT: REVISION: APPROVED BY: PURPOSE Risk Management Confined Space Entry Program POLICY NUMBER: SUPERSEDES: EFFECTIVE DATE: RMS-3 RMS-3 Rev.1 05/24/2023 Terrence R.Moore,ICMA-CM,City Manager The following Confined Space Entry Program has been established to ensure that effective controls are maintained to safeguard employees who enter confined spaces.All Departments with employees who enter confined spaces will participate in this Program.A copy of this written Program is available online on the City's website. POLICY A Each Department Head is responsible for the administration of this Program as it applies to the Department's various Divisions.This includes the development and maintenance of procedures which are specific to the various Divisions'operations and adhere,at a minimum,to the requirements of this Program. B.Each Department Head will designate a Program Coordinator for the Department or for each Division.The Program Coordinator(s)will then be trained in all aspects of this Program by the City's Safety Coordinator and will subsequently be responsible for ensuring that the requirements of this Program are met.The Program Coordinator(s)will conduct their activities in concurrence with the Department Head,Division Heads and their supervisors,and with the assistance of the City's Safety Coordinator as warranted. C.For the convenience of the Program Coordinator(s),appendices are attached to allow for compliance with the requirements of this Program.Any Department/Division may use other (existing)documentation providing it meets the intent of these appendices. DEFINITIONS •Acceptable Entry Conditions -The conditions that must exist within a confined space to ensure that the Entrant(s)can safely enter and perform work. Attendant-A trained employee authorized by the Department who is responsible for stationing himself/herself immediately outside of a permit-required confined space;monitoring the Entrants;and performing other duties as described in this Program.An Attendant is not required for entry operations at other types of confined spaces. •Blanking or Blinding -The absolute closing of a pipe,line,or duct by the fastening of a solid plate (i.e.,a spectacle or skillet blind)that completely covers the bore and that is capable of withstanding the maximum pressure of the pipe,line or duct with no leakage beyond the plate. •Confined Space-Any space that is large enough or so configured that an employee can bodily enter the space and perform work;and has limited or restricted means for entry or exit (i.e.,wet wells,can station, manholes and certain tanks,vessels,storage bins,vaults,and pits);and is not designed for continuous employee occupancy. •Confined Space,Certificate-Required -A confined space where the only hazard is the presence of or potential for a hazardous atmosphere (i.e.,flammable,toxic and/or improper oxygen concentration)which can be controlled by continuous forced air ventilation. •Confined Space,Clearance-Required -A confined space that contains hazards capable of causing serious physical harm which can be eliminated prior to entry. •Confined Space,Hazardous Non-Entry-A confined space (i.e.,a confined space which contains,or has the potential to contain,a hazardous atmosphere which cannot be controlled by continuous forced air ventilation,or which cannot be eliminated prior to entry)which the Department has determined will not be entered by employees or contractors. •Confined Space,Non-Permit/Certificate/Clearance -A confined space that does not contain,or have the potential to contain,any hazards capable of causing serious physical harm. •Confined Space,Permit-Required -A confined space that:contains a material (i.e.,water or sludge)that has the potential for engulfing an Entrant;and/or contains an internal configuration (i.e.,inwardly converging walls such as a silo)which could trap or asphyxiate an Entrant;and/or contains other recognized safety or health hazards such as mechanical or electrical hazards;and/or contains any of the aforementioned hazards in addition to containing,or having the potential to contain,a hazardous atmosphere which can be controlled by continuous forced air ventilation or which can be eliminated prior to entry. •Double Block and Bleed -The closure of a pipe,line,or duct by closing and locking out two in-line valves and then opening and locking out a drain or vent valve in the line between the two closed valves. •Engulfment-The surrounding capture of an Entrant by a liquid or finely divided (flowable)solid substance that can cause death by filling or plugging the respiratory system or that can exert enough force on the body to cause death by strangulation or crushing. •Entrant -A trained employee authorized by the Department to enter a confined space and perform duties as described in this Program. •Entry Supervisor-A trained supervisor authorized by the Department who is responsible for:determining if acceptable entry conditions exist at the permit-required or certificate-required confined space where entry is planned;authorizing entry;and performing other duties as described in this Program.An Entry Supervisor is not required for entry operations at other types of confined spaces. •Hazardous Atmosphere-An atmosphere within a confined space that may expose Entrants to the risk of death,incapacitation,impairment of ability to self-rescue (escape unaided from a confined space), injury or acute illness from one or more of the following causes:flammable gases,vapors or mists (i.e., Methane)in excess of 10 percent of their respective lower explosive limits;atmospheric concentrations of any toxic substances (i.e.,Carbon Monoxide,Hydrogen Sulfide)above their respective permissible exposure limits;and/or atmospheric oxygen concentrations below 19.5%(oxygen deficient)or above 23.5%(oxygen enriched)-see the City's Respiratory Protection Program. •lnerting -The displacement of a combustible atmosphere within a confined space by a noncombustible gas (i.e.,Nitrogen)to such an extent that the resulting atmosphere is noncombustible.As this procedure creates an oxygen deficient atmosphere,continuous ventilation must subsequently be provided for the duration of entry to provide proper atmospheric oxygen concentrations. •Isolation -The process by which a permit-required confined space is completely protected against the release of energy or material into the confined space by such means as:blanking or blinding;misaligning or removing sections of pipes,lines or ducts;a double block and bleed system;lockout or tagout of all sources of energy (see the City's Hazardous Energy Control Program);and/or blocking or disconnecting all mechanical linkages. •OSHA Standard 1910.146 -Federal government regulation which can be referenced for Permit Required Confined Space Entry information. •Program Coordinator -An employee designated by the Department Head who is trained in all aspects of this Program and coordinates all Program activities for the Department or for a Division. •Prohibited Conditions -Any conditions (i.e.,welding)within a permit-required confined space that is not allowed by the Permit during the time period when entry is authorized. •Retrieval System -The equipment (i.e.,harnesses,tripods,winches)used for non-entry rescue of Entrants from permit-required confined spaces. •Testing -The process by which potential hazardous atmospheres that may confront Entrants of a confined space are identified and evaluated. PROCEDURE A.CLASSIFICATION OF CONFINED SPACES 1.In conjunction with the applicable Division Heads and their supervisors,Program Coordinators must initially identify and evaluate all confined spaces,by Division,within their respective Departments and classify (permit-required,certificate-required,clearance-required,hazardous non-entry or non- permit/certificate/clearance)each confined space based on the definitions of the classifications of confined spaces noted above. 2.This initial evaluation of each confined space will require testing of the space's atmosphere (see Atmospheric Testing data below)to determine if the atmosphere is hazardous and then a physical inspection of the space to determine which,if any,physical hazards (i.e.,chemical,electrical,mechanical, engulfment,temperature,noise,or vibration)are present.During these initial evaluations,the confined spaces will be assumed to be permit-required.Therefore.the procedures for permit-required confined space entry referred to further in this Program must be followed until the proper classification of each confined space is determined. 3.During the evaluations,a Confined Space Data Form (see Appendix "A"attached)must be completed for each confined space.Information required to complete Entry Permits and Entry Certificates will,in large part,be obtained from these Data Forms. 4.After the evaluations have been completed,each confined space must be recorded by classification on the Confined Space Inventory Form -see Appendix "B"attached. 5.From time to time.hazards within a confined space may change.When this occurs.the confined space must be reevaluated and possibly reclassified.To maintain information current,all pertinent information must be changed on the applicable Confined Space Data Form and any classification changes must be recorded on the Confined Space Inventory Form. B.ATMOSPHERIC TESTING 1.Program Coordinators will ensure that only an OSHA (Occupational Safety &Health Administration) compliant microprocessor-controlled multi-gas detector/monitor is used:to initially evaluate the atmosphere within a confined space to properly classify the confined space;to test the atmosphere within a confined space prior to entry to determine if acceptable entry conditions exist;and to continuously monitor the atmosphere within a confined space during entry to ensure that acceptable entry conditions are maintained. 2.Appropriate representatives of the detector/monitor units'manufacturers will be used as a resource to determine which gases to test/monitor for (i.e.,in the case of the City's lift station wet wells -Hydrogen Sulfide,Methane,Carbon Monoxide and Oxygen).Specific procedures must be developed by each Department for the calibration and use of each different type of unit provided to their employees.If any problems are encountered with this activity,contact the City's Safety Coordinator for assistance. 3.The manufacturers of the detector/monitor units MUST be contacted initially for information regarding proper calibration of the units'sensors so that safe parameters for each gas,vapor,or mist to be monitored is established.Subsequently,an employee authorized by the Department will calibrate the units based on the manufacturers'specifications and will continue to do so,usually monthly.This authorized employee will also clean the units,and recharge the batteries as needed.Calibration and repair activities (i.e.,replacement of a sensor)must be done per the manufacturers'specifications and must be documented. C.CONFINED SPACE ENTRY PROCEDURES Program Coordinators,in conjunction with the applicable Division Heads and their supervisors,must develop and maintain confined space entry procedures for all confined spaces within their respective Departments.The following information for the various types of confined spaces must be included in any such procedures: 1.Permit-Required Confined Space (also refer to ENTRY PERMIT and PERSONNEL DUTIES) a.An Entry Permit must be completed prior to any permit-required confined space entry.All Departments will use the same type of Entry Permit -see Appendix "C". b.The information required to complete the Entry Permit can be found,in large part,on the corresponding Confined Space Data Form -see Appendix "A". c.The duration of the Entry Permit must not exceed the time required to complete the work to be performed as indicated on the Permit. d.An Entrant must test atmospheric conditions within the confined space without bodily entering the space to determine if acceptable entry conditions exist.If an unknown potentially hazardous atmosphere is detected (e.g..,the odor/appearance of gases,vapors or mists not indicated on the Permit),the Entrant Tester must immediately notify the Entry Supervisor,who will immediately notify the Department/Division Head.The confined space will not be entered.No entry will be made until the unknown potentially hazardous atmosphere is identified and appropriate atmospheric testing,entry and hazard control procedures are put in place. e.Ensure that any measures to be taken to isolate the space have been completed and that all equipment required by the Permit has been appropriately positioned as close as possible to the space portal. f.A tripod/winch assembly,or equivalent,is required for any permit-required confined space entry when the vertical entry is greater than 5 feet. g.Provide pedestrian,vehicle,or other barriers as necessary to protect Entrants from external hazards before accessing confined space entry portals. h.Any conditions making it unsafe to open or remove the portal covers must be eliminated before the covers are opened or removed. i.When portal covers are opened or removed,Department procedures must be followed to protect against accidental falls through the openings and foreign objects from entering the space. j.The Entry Supervisor will inspect the permit space site to ensure that all conditions of the Entry Permit have been met before signing the Permit to authorize entry.The Entry Supervisor is then allowed to leave the permit space site. k.An Attendant must be stationed immediately outside the entry portal to monitor and protect all Entrants. I.Entrants must follow established safety procedures and be properly trained in the use of all personal protective equipment. m.If forced air ventilation is being used to maintain the permit space free of a hazardous atmosphere,the air supply must be from a clean source,must not increase the hazards in the space and must be so directed as to ventilate the areas within the space where the entrants will be located during entry.An Entrant must continuously monitor the atmosphere while occupying the permit space for the duration of entry.If a gas detector alarm sounds,all Entrants must immediately leave the space.The Department must then reevaluate the space to determine how the hazardous atmosphere accumulated and what measure must be implemented to protect Entrants from the hazardous atmosphere before any subsequent entry takes place. n.The Attendant will maintain communication with all Entrants via the following methods:visual,voice, established signals and/or radio.In any case,the Attendant must maintain the use of a radio to contact the Entry Supervisor and Fire Rescue in the event of an emergency-see Emergency Rescue information further in this Program. o.No smoking will be allowed within the space or near the entry portals. p.No bottom or side entry will be made into the space,and no work will be conducted below the level at which any material could cause engulfment. q.After all work has been completed in the permit space,the Attendant can terminate the entry and complete the "Remarks"section of the Entry Permit.The permit space will then be put back into operation by securing the entry portals,removing all barriers,tools,and equipment,and restoring any signage. r.The Entry Supervisor will subsequently inspect the site,sign the Entry Permit to cancel it and file the cancelled Permit with the Program Coordinator. s.See additional information further in this Program regarding WARNING SIGNS and CONTRACTORS. 2.Certificate-Required Confined Space (Also refer to ENTRY CERTIFICATE and PERSONNEL DUTIES) a.An Entry Certificate must be completed prior to any certificate-required confined space entry.All Departments will use the same type of Entry Certificate -see Appendix "D". b.The information required to complete the Entry Certificate can be found,in large part,on the corresponding Confined Space Data Form. c.The duration of the Entry Certificate must not exceed the time required to complete the work to be performed as indicated on the Certificate. d.An Entrant must test atmospheric conditions within the confined space without bodily entering the space to determine if acceptable entry conditions exist.If an unknown potentially hazardous atmosphere is detected (e.g.,the odor/appearance of gases,vapors or mists not indicated on the Permit),the Entrant Tester must immediately notify the Entry Supervisor,who will immediately notify the Department/Division Head.The confined space will not be entered.No entry will be made until the unknown potentially hazardous atmosphere is identified and appropriate atmospheric testing,entry and hazard control procedures are put into place. e.Provide pedestrian,vehicle,or other barriers as necessary to protect Entrants from external hazards before accessing confined space entry portals. f.Any conditions making it unsafe to open or remove the portal covers must be eliminated before the covers are opened or removed. g.When portal covers are opened or removed,Department procedures must be followed to protect against accidental falls through the openings and foreign objects entering the space. h.The Entry Supervisor will inspect the certificate space site to ensure that all conditions of the Entry Certificate have been met before signing the Certificate to authorize entry.The Entry Supervisor is then allowed to leave the certificate space site. i.Entrants must follow established safety procedures and be properly trained in the use of all personal protective equipment. j.The air supply for the forced air ventilation being used to maintain the certificate space free of a hazardous atmosphere must be from a clean source,must not increase the hazards in the space and must be so directed as to ventilate the areas within the space where the entrants will be located during entry.An Entrant must continuously monitor the atmosphere while occupying the certificate space for the duration of entry.If a gas detector alarm sounds,all Entrants must immediately leave the space.The Department must then reevaluate the space to determine how the hazardous atmosphere accumulated and what measures must be implemented to protect Entrants from the hazardous atmosphere before any subsequent entry takes place. k.No smoking will be allowed within the space or near the entry portals. I.After all work has been completed in the certificate space,the Entrants can terminate the entry and complete the "Remarks"section of the Entry Certificate.The certificate space will then be put back into operation by securing the entry portals,removing all barriers,tools,and equipment,and restoring any signage. m.The Entry Supervisor will subsequently inspect the site,sign the Entry Certificate to cancel it and file the cancelled Certificate with the Program Coordinator. n.See additional information further in this Program regarding WARNING SIGNS and CONTRACTORS. 3.Clearance-Required Confined Space (Also refer to ENTRY CLEARANCE and PERSONNEL DUTIES) a.An Entry Clearance must be completed and signed by any "authorized"employee after it has been determined that all hazards in the space have been eliminated prior to any confined space entry.All Departments will use the same type of Entry Clearance -see the attached Entry Clearance (Appendix E) b.Provide pedestrian,vehicle,or other barriers as necessary to protect Entrants from external hazards before accessing confined space entry portals. c.Any conditions making it unsafe to open or remove the portal covers must be eliminated before the covers are opened or removed. d.When portal covers are opened or removed,Department procedures must be followed to protect against accidental falls through the openings and foreign objects from entering the space. e.Entrants must follow established safety procedures. f.No smoking will be allowed within the space or near the entry portals. g.After all work has been completed in the clearance space,the Entrants can terminate the entry.The clearance space will then be put back into operation by securing the entry portals,removing all barriers, tools,and equipment,and restoring any signage. h.See additional information further in this Program regarding WARNING SIGNS and CONTRACTORS. 4.Hazardous Non-Entry Confined Space a.Since the Department has determined that this type of confined space will not be entered by employees and/or contractors,no specific procedures apply except that Warning Signs (see information further in this Program regarding Warning Signs)must be posted prohibiting any entry and entry portals must be secured. b.If the Department decides at any time that this type of confined space must be entered by employees and/or contractors,the Department must reevaluate the space and classify it as a permit-required, certificate-required,clearance-required,or non-permit/certificate/clearance confined space.This reevaluation and reclassification must be done before any entry is allowed. 5.Non-Permit/Certificate/Clearance Confined Space (Also refer to PERSONNEL DUTIES) a.Provide pedestrian,vehicle,or other barriers as necessary to protect Entrants from external hazards before accessing confined space entry portals. b.Any conditions making it unsafe to open or remove the portal covers must be eliminated before the covers are opened or removed. c.When portal covers are opened or removed,Department procedures must be followed to protect against accidental falls through the openings and foreign objects from entering the space. d.Entrants must follow established safety procedures. e.No smoking will be allowed within the space or near the entry portals. f.After all work has been completed in the confined space,the Entrants can terminate entry.The confined space will then be put back into operation by securing the entry portals,removing all barriers,tools,and equipment,and restoring any signage. g.See additional information further in this Program regarding WARNING SIGNS and CONTRACTORS. D.ENTRY PERMIT_(Also refer to PERSONNEL DUTIES) The Entry Permit form (Appendix "C")is required as a prerequisite to entering a Permit-Required confined space. This Permit must be completed in part by the Entry Supervisor from information obtained from the applicable Confined Space Data Form.To ensure acceptable entry conditions,the Attendant/Entrants must perform all required testing/assessments required by the Permit,which will subsequently be reviewed and signed by the Entry Supervisor before entry is authorized. The signed Entry Permit must be posted at or as close as possible to the confined space entry portal for inspection by the Entrants for the duration of the entry activities. The Attendant must terminate entry and the Entry Supervisor must cancel the Permit when the entry operations specified on the Permit have been completed or when an emergency or condition that is not allowed under the Entry Permit arises in or near the permit space.Canceled Permits must be filed with the applicable Program Coordinator who will retain the permits for at least one year,periodically reviewing the Permits to determine if any permit-required confined spaces merit reevaluation and possible reclassification. Also refer to information earlier in this Program regarding CONFINED SPACE ENTRY PROCEDURES. E.ENTRY CERTIFICATE (Also refer to PERSONNEL DUTIES) The Entry Certificate (Appendix "D")is required as a prerequisite to entering a certificate-required confined space.The Entry Supervisor will complete the Certificate in part from information obtained from the applicable Confined Space Data Form.To ensure acceptable entry conditions,the Entrants must perform all required testing/assessments and complete the remaining portion of the Entry Certificate which will subsequently be reviewed and signed by the Entry supervisor before entry is authorized. The signed Entry Certificate must be posted at or as close as possible to the confined space entry portal for inspection by the Entrants for the duration of the entry activities. The Entry Supervisor will return to the certificate space site after being notified by the Entrant that entry operations have been completed to verify that the site has been properly put back into operation and to sign (cancel)the Entry Certificate. Also refer to information earlier in this Program regarding CONFINED SPACE ENTRY PROCEDURES. F.ENTRY CLEARANCE (Also refer to PERSONNEL DUTIES) The Entry Clearance form (Appendix "E")is required as a prerequisite to entering a clearance-required confined space.The Entry Clearance must be completed and signed by the authorized employee making the determination that all hazards in the space have been eliminated. The signed Entry Clearance must be made available to all Entrants for inspection before they enter the confined space. Also refer to information earlier in this Program regarding CONFINED SPACE ENTRY PROCEDURES. G.PERSONNEL DUTIES All personnel involved in confined space entry activities will have specific assigned duties.For Entry Supervisors, see Appendix "H"(Entry Supervisor Duties).For Attendants,see Appendix "I"(Attendant Duties).And,for Entrants,see Appendix "J"(Entrant Duties). Also refer to information earlier in this Program regarding CONFINED SPACE ENTRY PROCEDURES.ENTRY PERMIT,ENTRY CERTIFICATE and ENTRY CLEARANCE. H.WARNING SIGNS If a confined space is classified as either permit-required,certificate-required,clearance-required,or hazardous non-entry,the Department must identify the dangers posed by the space by installing a warning sign either on, or as close as possible to the space's entry portal.The sign must read as follows: DANGER CONFINED SPACE DO NOT ENTER WITHOUT WRITTEN AUTHORIZATION The sign must be made of metal or plastic to withstand the elements and must be securely fastened to its attachment to ensure against unauthorized removal. I.EMERGENCY RESCUE If an Entrant within a permit-required confined space is involved in an emergency situation (i.e.,injury,engulfment or being overcome by a hazardous atmosphere),the Attendant on site must immediately call Fire Rescue and the Entry Supervisor.The Attendant may attempt to non-entry rescue of the Entrant while Fire Rescue is in route by using mechanical equipment on-site such as a tripod/winch assembly to carefully remove the Entrant from the confined space,if this activity in no way exposes the Entrant to further harm.Under no circumstances shall the Attendant attempt to enter the confined space.If the Entrant is successfully retrieved from the confined space and emergency medical care is warranted,the Attendant may administer First Aid/CPR to the Entrant until Fire Rescue arrives. J.CONTRACTORS When a contractor has the occasion to work within a Department's permit-required confined space,the applicable Program Coordinator must conduct the following activities: Inform the contractor that entry into the Department's permit-required confined space is allowed only if the contractor complies with the requirements of this Program,or any other Program if it can be shown that the Program meets,at a minimum,the requirements of this Program. Inform the contractor of the hazards associated with the permit-required confined space to be entered. Apprise the contractor of the procedures the Department has implemented to protect its employees that work in or near the permit-required confined space where the contractor's employees will be working. Develop and implement procedures to coordinate entry operations when the Department's and the contractor's employees will work simultaneously within a permit-required confined space so that the contractor's employees do not endanger the Department's employees and vice versa. Debrief the contractor at the conclusion of the entry operations inquiring if the contractor followed the requirements of the Confined Space Entry Program and if the contractor confronted any unexpected hazards or created any hazards during entry operations. K.PROGRAM EVALUATION 1.To ensure that this Program is being properly maintained,Program Coordinators will conduct on-going evaluations of this Program.The evaluations will be keyed towards a review of the following matters, documented in permit and certificate files,to determine if procedural changes in this Program are required or if reclassifications of certain confined spaces are warranted: Any unauthorized entry of a permit space. The detection of permit space hazards not indicated on the Entry Permit. The detection of conditions prohibited by the Entry Permit. The occurrence of an accident or near-miss accident during entry. A change in the use or configuration of a permit space. Employee complaints regarding the effectiveness of this Program. 2.Program Coordinators will ensure that information regarding procedural changes and/or confined space reclassifications is documented and communicated to all affected employees. L.EMPLOYEE TRAINING 1.All Entry Supervisors,Attendants and Entrants will be trained initially regarding the following: An overview of the requirements contained in this Confined Space Entry Program. Definitions associated with this Program. How confined space classifications are determined. The Department's and/or Division's procedures for confined space entry. The Department's and/or Division's list of confined spaces. Atmospheric testing procedures. The confined space entry equipment that will be used. Duties of Entry Supervisors,Attendants and Entrants. Completion of Entry Permits,Entry Certificates and Entry Clearances. Confined space warning signs. Emergency rescue procedures. Program evaluation activities. 2.Program Coordinators will ensure that the above-mentioned training is provided,via verbal instruction and the use of a provided training video,for all Entry Supervisors,Attendants and Entrants.See the attached Employee Training Outline and Training Documentation Form (Appendix "F"and "G", respectively). 3.Retaining of applicable Entry Supervisors,Attendants and Entrants will be provided by the Program Coordinators if:there is a change in assigned personnel duties;there is a change in permit-required confined space operations such that new hazards are created;or when procedural deficiencies are observed which indicate that additional training is required. Appendix A B C D E F G H I d CONFINED SPACE ENTRY PROGRAM "APPENDICES" Contents Confined Space Data Form Confined Space Inventory Form Entry Permit Entry Certificate Entry Clearance Employee Training Outline Training Documentation Form Entry Supervisor Duties Attendant Duties Entrant Duties Appendix "A" CITY OF DEL RAY BEACH Confined Space Entry Program Confined Space Data Form De p artm e nt:I Div ision : P ro gram Co o rdin ato r: Co nfi n e d Space N a m e :I Lo cati o n : Descripti o n of Co n fi n e d Sp ace : Classifi cati o n (p e rm it-re q u ired ,ce rti fi cate-req u ired ,etc.): W ill co nfi n e d sp a ce be ente red ?Yes No -If Yes,ho w oft e n : Type of w o rk to be pe rfo rm e d : Ch eck A ll Po te ntial Hazards Hazardo u s A tm o sp h eres Physic al Hazard s Flam m ab le Entrap m e nt Electric al eq uip m ent Toxic Engu lfm e nt M e ch an ical equ ip m ent Irritan t Che m icals Rad iati on Co rrosive Tem p e rature Ho t w o rk O xygen de fi ci e nt/e nr iched No ise Entry/exit Ot he r:V ib rati on O the r: Check All Req u ired Hazard Co n tro ls/Equ ip m e nt A ir m o nito ring Retrieval eq u ip .(i.e .,trip o d ,w in ch,harn ess,bod y suit) Fo rced air ve nti lati o n Co m m u n ic ati on s ln e rti ng PPE (i.e .,hard hat,go ggle s,glo ves,safety sh o e s) Do u b le blo ck/b le e d He aring protecti on Bla n k ing /b li n d in g Resp irato rs Po sted M SD S's Lo ck out/tag o ut Barrie rs (i.e .,co n e s,ho rses Exp lo sion-p roo f eq u ip m e nt Li ghti n g O th e r: If a hazardous atmosphere exists or has the potential to develop: To establish Acceptable Entry Conditions,the manufacturer of the multi-gas detector/monitor unit that will be used to test the atmosphere within the confined space MUST be contracted for information concerning proper calibration of the unit's sensors (for permissible exposure limits)with respect to the gases,vapors,mists and air contaminants checked below: Oxygen Methane Carbon Monoxide Hydrogen Sulfide Other (specify) () () () () () Procedures required to isolate confined space (i.e.,lock out/tag out,block &bleed,blanking): Conditions prohibited during entry (i.e.,welding,etc.):_ Appendix "B" CITY OF DELRAY BEACH Confined Space Entry Program Confined Space Inventory Form Depart m ent: Program Coordinator: I Division: Confined Space Name Location *Classification *Classification of Confined Spaces: A-Permit-Required B -Certificate-Required C-Clearance-Required D -Hazardous Non-Entry E -Non-Permit/Certificate/Clearance Appendix "C" CITY OF DEL RAY BEACH Confined Space Entry Program Section I (Entry Supervisor) Department:I Division: Entry Supervisor:I Attendant:I Entrants: Confined Space Name:I Location: Work to be performed:I Duration of permit: Entry Permit Potential Hazards (check all that apply) Hazardous Atmospheres Physical Hazards Flammable Entrapment Electrical equipment Toxic Engulfment Mechanical equipment Irritant Chemicals Radiation Corrosive Temperature Welding,etc. Oxygen deficient/enriched Noise Entry/exit Other:Vibration Other: Hazard Controls/Equipment (check all that apply) Air Monitoring Traffic Cones Hard Hat Forced Air Ventilation (Blowers)Lighting Body Suit lnerting Explosion-Proof Equip.Safety Shoes Double Block/Bleed Eye Protection Gloves Blanking/Blinding Hearing Protection Tripod/Winch Posted MSDS'Respirators Communications Barriers Lock Out/Tag Out Other: "Isolation Procedures",if applicable (i.e.,lock out/tag out,block &bleed,blanking): "Prohibited Conditions",if applicable: Section II (Entrant Tester)-Hazardous Atmospheres Hazardous Air Monitoring Equipment Make/Model:I Serial Number: Date/Time Calibrated:I User's Name: Oxygen: Flammable Gases,Vapors or Mists: Toxic Air Contaminants: Safe Level ( Methane:Safe Level ( Carbon Monoxide:Safe Level ( Hydrogen Sulfide Safe Level ( Safe Level ( Do Not Enter ( Do Not Enter ( Do Not Enter ( Do Not Enter ( Do Not Enter (Other Hazardous Atmospheres:_ NOTE:City air monitoring units typically use "light bulb"indicators which will show safe (or unsafe)concentrations of pre-determined hazardous atmospheres.If other type units are to be used,specific instruction must be received by the User. Entrant Tester (sign):_ I Section Ill (Entry Supervisor)-Authorization to Enter Confined Space Entry Supervisor (sign):_ Section IV (Attendant/Entrants)-Termination of Entry •Permit space must be restored to normal operation. Remarks (i.e.,accidents,unauthorized entry or other unplanned conditions): Date/Time:_ Date/Time:_ Attendant (sign):_ I Section V (Entry Supervisor)-Cancellation of Permit Entry Supervisor (sign):_ Date/Time:_ Date/Time:_ Appendix "D" CITY OF DEL RAY BEACH Confined Space Entry Program Section I (Entry Supervisor) Department:Division: Entry Supervisor:Entrants: Confined Space Name:Location: Work to be performed:Duration of certificate: Type of hazardous atmosphere: Entry Certificate Section II (Entrant Tester)-Hazardous Atmospheres Hazardous Air Monitoring Equipment Make/Model:I Serial Number: Date/Time Calibrated:I User's Name: Oxygen: Flammable Gases,Vapors or Mists: Toxic Air Contaminants: Safe Level ( Methane:Safe Level ( Carbon Monoxide:Safe Level ( Hydrogen Sulfide Safe Level ( Safe Level ( Do Not Enter ( Do Not Enter ( Do Not Enter ( Do Not Enter ( Do Not Enter (Other Hazardous Atmospheres:_ NOTE:City air monitoring units typically use "light bulb"indicators which will show safe (or unsafe)concentrations of pre-determined hazardous atmospheres.If other type units are to be used,specific instruction must be received by the User. Entrant Tester (sign):_ Section Ill (Entry Supervisor)-Authorization to Enter Confined Space Entry Supervisor (sign):_ Section IV (Entrants)-Termination of Entry •Permit space must be restored to normal operation. Remarks (i.e.,accidents,unauthorized entry or other unplanned conditions): Date/Time:_ Date/Time:_ Entrant (sign):Date/Time:_ Section V (Entry Supervisor)-Cancellation of Permit Entry Supervisor (sign):_Date/Time:_ Appendix "E" CITY OF DELRAY BEACH Confined Space Entry Program Entry Clearance Section I Department: Confined Space Name: Section II (Identified Hazardous) I Section Ill (How were hazards eliminated?) Division: Location: Date: Section IV (Authorized employee who determined that hazards were eliminated.) Authorized Employee (sign):_Date/Time:_ Appendix "E" CITY OF DELRAY BEACH Confined Space Entry Program Employee Training Outline I.Explain the reason for a Confined Space entry Program and the City's policy. II.Show the provided video. Ill.Provide each confined space Entry Supervisor,Attendant and Entrant with a copy of this Program (with appendices)and the Department's and/or Divisions'procedures for confined space entry. IV.Review the definitions indicated in this Program. V.Show employees the confined space entry equipment they will use (atmospheric monitoring devices and tripod/winch assemblies,etc.)and demonstrate how each operates. VI.Review this Program's requirements: a.Confined Space Classification Determination: i.Explain that the Program Coordinator is responsible to classify all confined spaces in the Department in conjunction with Division Heads and their Supervisors. ii.Discuss the activities that will be conducted to determine these classifications. iii.Review the Confined Space Data Form (Appendix "A")and the Confined Space Inventory Form (Appendix "B") b.Confined Space Entry Procedures: i.Review the Department's and/or Division's confined space entry procedures including atmospheric testing procedures. c.Personnel Duties: i.Review with each employee Appendix "H"(Entry Supervisor Duties),Appendix "I"(Attendant Duties)and Appendix "J"(Entrant Duties).Employees should retain these appendices to serve as a future quick reference. d.Entry Permit: i.Explain the reason for an Entry Permit. ii.Discuss the activities involved in completing an Entry Permit. iii.Review the Entry Permit (Appendix "C"). e.Entry Certificate: i.Explain the reason for an Entry Certificate. ii.Discuss the activities involved in completing an Entry Certificate. iii.Review the Entry Certificate (Appendix "D"). f.Entry Clearance i.Explain the reason for an Entry Clearance. ii.Review the Entry Clearance (Appendix "E"). g.Warning Signs: i.Explain the reason for warning signs. ii.Review this Program's requirements for warning signs. h.Emergency Rescue: i.Review this Program's requirement for emergency rescue from a permit-required confined space. ii.Stress that an Attendant must never attempt to enter the space to rescue an Entrant.Rather,an Attendant may attempt a non-entry rescue as described in this Program. 111.Explain that Attendants must be trained and qualified in First Aid/CPR. i.Informing Contractors: i.Review the required procedures for informing contractors of the City's Confined Space Entry Program. ii.Explain the importance of providing effective coordination of activities when the Department's and the contractor's employees are working together within the same confined space. j.Program Evaluations: i.Describe program evaluation activities. ii.Emphasize the role of the evaluation and its importance to the overall effectiveness of this Program. VII.Review the Department's and/or Divisions'procedures for confined space entry. VIII.Summarize. IX.Allow time for questions and answers. Appendix "G" CITY OF D EL RAY BEA CH Confined Space Entry Program Training Documentation Form Department:I Division: Date of Training: Program Coordinator: Topic Discussed:Confined Space Entry Program Employees in Attendance: Name (print)Signature Appendix "H" CITY OF DEL RAY BEACH Confined Space Entry Program Entry Supervisor Duties N o te:The info rm ati o n in this A ppe nd ix is intended fo r Att enda nts w ho m ust be trained and kno w le dgeab le concern ing each bulleted item . Entry Sup e rviso r's duti es fo r pe rm it-req u ired confi ned space entry : •Complete applicable sections of the Entry Permit based on information noted on the applicable Confined Space Data Form. •Know the hazards that may be faced during entry,including information regarding the mode,symptoms and consequences of the exposure. •Confirm that Attendants and Entrants have received appropriate training in and are qualified to perform their assigned tasks. •Confirm that all safety procedures and equipment specified by the Entry Permit are in place (and equipment operable),that all tests specified by the Permit have been conducted and that the permit has been properly completed before signing the Permit and allowing entry operations to begin. •Allowed to leave the permit space site at the conclusion of the above noted activities. •Return to the permit space site to provide guidance and supervision if notified by the Attendant that an emergency has occurred or that a condition that is not allowed by the Permit has arisen. •Return to the permit space site after being notified by the Attendant that entry operations have been completed to verify that the site has been properly put back into operation and to sign (cancel)the Entry Permit. •Subsequently,file the cancelled Permit with the applicable Program Coordinator. Entry Supe rviso r's duti es fo r ce rti fi cate-req u ired confi ned space entry : •Complete applicable sections of the Entry Certificate based on information noted on the applicable Confined Space Data Form. •Know the hazards that may be faced during entry,including information regarding the mode,symptoms and consequences of the exposure. •Confirm that Entrants have received appropriate training in and are qualified to perform their assigned tasks. •Confirm that all appropriate safety procedures and equipment specified by the Entry Certificate are in place,that all tests specified by the Certificate have been conducted and that the Certificate has been properly completed before signing the Certificate and allowing entry operations to begin. •Allowed to leave the certificate space site at the conclusion of the above noted activities. •Return to the certificate space site after being notified by the Entrant that entry operations have been completed to verify that the site has been properly put back into operation and to sign (cancel)the Entry Certificate. •Subsequently,file the cancelled Certificate with the applicable Program Coordinator. Note:Entry Supervisors are not required for entry operations in Clearance-Required or Non- Permit/Certificate/Clearance confined spaces. Appendix "I" CITY OF DELRAY BEACH Confined Space Entry Program Attendant Duties No te:The info rm ati on in this A ppe nd ix is intended fo r Att endants w ho m ust be trained and kno w le dgeab le concern ing each bulleted item . A tt end a nt's duti e s fo r perm it-required confi ned space entry : •Know the hazards that may be faced during entry,including information regarding the mode,symptoms and consequences of the exposure. •Perform no duties that might interfere with the Attendant's primary duty which is to monitor and protect the Entrants. •Be trained and qualified in First Aid/CPR. •Ensure that all equipment required by the Entry Permit (i.e.,atmospheric monitoring devices,non-entry rescue equipment and mechanical blowers,etc.)is inspected,including calibration of monitoring devices,and in good working condition before use. •Remain immediately outside the permit pace during entry operations unless and until relieved by another Attendant. •Ensure that entry operations are consistent with terms of the Entry Permit and that acceptable entry conditions are maintained. •Maintain an accurate count and identification of each Entrant in the permit space. •Communicate with Entrants as necessary to monitor Entrants'status and to alert Entrants of the need to evacuate the permit space if:a gas detector alarm sounds:any behavioral effects of hazard exposure in any Entrant are detected;a prohibited condition is observed;a situation arises outside the permit space which could endanger the Entrants;or the Attendant cannot continue to effectively and safely perform all the duties required of his/her position. •Call 911 (Fire Rescue)and the Entry Supervisor as soon as it becomes evident that Entrants may need assistance to escape from a permit hazard or if an Entrant is injured. •Attempt a non-entry rescue of an Entrant while Fire Rescue is in route. •Under no circumstances shall the Attendant enter the permit space during entry operations. •Take the following actions when unauthorized persons approach or enter a permit space during entry operations: warn the unauthorized persons that they must stay away from the permit space or,if they have entered,advise them that they must exit immediately and inform the Entry Supervisor and the Entrants if the unauthorized persons refuse to exit the permit space. •Notify the Entry Supervisor if an emergency occurs or if a condition that is not allowed by the Entry Permit arises in or near the permit space. •Terminate the entry and put the permit space back into operation when the entry operations have been completed by securing the entry portals,removing all barriers,tools and equipment,and restoring any signage. •Notify the Entry Supervisor that the entry has been terminated and that the permit space has been put back into operation. •Complete the "Remarks"section of the Entry Permit and return it to the Entry Supervisor. Note:Attendants are not required for entry operations in Certificate-Required,Clearance-Required or Non- Permit/Certificate/Clearance confined spaces. Appendix "J" CITY OF DEL RAY BEACH Confined Space Entry Program Entrant Duties No te :The info rm ati o n in this A ppe nd ix is intende d fo r Entrants w ho m ust be trained and kno w le dge ab le co ncern ing each bulleted item . Entrant's duti es fo r perm it-req u ired co nfi ned space entry : •Complete Section II (Entrant Tester),Hazardous Atmospheres,of the Entry Permit.Entrant is responsible to test the atmosphere of the confined space and record the test results prior to entry to ensure safe conditions exists. •Know the hazards that may be faced during entry,including information regarding the mode,symptoms ad consequences of the exposure. •Properly use all equipment specified on the Entry Permit. •Wear all personal protective equipment specified by the Entry Permit. •Follow established safety procedures. •Continually monitor atmospheric conditions as specified by the Entry Permit. •Notify the Attendant immediately if any warning signs or symptoms of exposure to a dangerous situation are recognized in any Entrant or if a prohibited condition is detected. •Communicate as necessary with the Attendant to enable the Attendant to effectively monitor the Entrants'status ad to alert Entrants of the need to evacuate the permit space if required. •Immediately evacuate the permit space if instructed to do so by the Attendant or the Entry Supervisor,or if a gas detector alarm sounds. •After all work has been completed in the permit space,put the permit space back into operations by securing the entry portals,removing all barriers,tools and equipment,and restoring any signage. Entrant's duti es fo r certi fi cate-requ ired co nfi ne d space entry : •Complete Section II (Entrant Tester),Hazardous Atmospheres,of the Entry Certificate.Entrant is responsible to test the atmosphere of the confined space and record the test results prior to entry to ensure safe conditions exist. •Know the hazards that may be faced during entry,including information regarding the mode,symptoms and consequences of the exposure. •Properly use all equipment specified on the Entry Certificate. •Wear all personal protective equipment specified by the Entry Certificate. •Follow established safety procedures. •Continually monitor atmospheric conditions as specified by the Entry Certificate. •Evacuate the certificate space and notify the Entry Supervisor immediately if any warning signs or symptoms of exposure to a dangerous situation are recognized in any Entrant or if a gas detector alarm sounds. •After all work has been completed in the certificate space,put the certificate space back into operation by securing the entry portals,removing all barriers,tools and equipment,and restoring any signage. •Notify the Entry Supervisor that entry operations have been completed. •Entrants may begin entry operations only after the person authorized by the Department has determined that all hazards in the clearance space have been eliminated and the signed Entry Clearance form has been made available to all Entrants. •Properly use all required equipment. •Wear all required personal protective equipment. •Follow established safety procedures. •After all work has been completed in the clearance space,put the clearance space back into operation by securing the entry portals,removing all barriers,tools and equipment,and restoring any signage. Entrant's duti es fo r non-pe rm it/ce rti fi cate/cl e arance-required confi ned space entry : •Properly use all required equipment. •Wear all required personal protective equipment. •Follow established safety procedures. •After all work has been completed in the clearance space,put the clearance space back into operation by securing the entry portals,removing all barriers,tools and equipment,and restoring any signage. NOTE:NO ENTRY IS ALLOWED INTO A HAZARDOUS NON-ENTRY CONFINED SPACE.