Safety & Compliance · Permit & Log

Confined Space Entry Permit Atmospheric Testing Log

Mandatory pre-entry permit used to document atmospheric testing results, hazard controls, and authorization before any confined space entry. Complies with WorkSafeBC OHS Regulation Part 9 and OSHA 29 CFR 1910.146.

Frequency
Per Entry / Daily
Department
Health & Safety
Regulation
WorkSafeBC / OSHA 1910.146
Version
1.0
Free download — no sign‑up, no email.Take this permit or log to your shop floor and mount it on a clipboard.
Overview & Purpose

This Confined Space Entry Permit & Atmospheric Testing Log is a controlled document used to verify that the atmosphere inside a confined space is safe for entry. It requires calibrated gas detection equipment to measure oxygen concentration, flammable gas (LEL), hydrogen sulfide (H2S), and carbon monoxide (CO). The permit must be completed prior to each entry and retained for the duration of the work. All entries must be signed off by a competent supervisor.

Hazard Assessment Prerequisites
  • CONTROLConfirm lockout/tagout of all energy sources, mechanical isolation, and line breaking.
  • VENTContinuous forced air ventilation in place and verified before and during entry.
  • STANDBYTrained standby person assigned, with retrieval equipment and communication system.
  • CALGas monitor calibrated within 30 days and bump-tested before use.
  • PPERequired PPE: hard hat, safety glasses, gloves, steel-toed boots; additional based on hazards.

Atmospheric Testing & Compliance Matrix

Status (P/F) Checklist Item / Hazard Compliance Standard Action Required / Notes
[ ] Pass [ ] Fail Oxygen concentration (O₂) 19.5% – 23.5% _________________
[ ] Pass [ ] Fail Flammable gas (% LEL) < 10% of Lower Explosive Limit _________________
[ ] Pass [ ] Fail Hydrogen sulfide (H₂S) < 10 ppm _________________
[ ] Pass [ ] Fail Carbon monoxide (CO) < 35 ppm _________________
[ ] Pass [ ] Fail Volatile organic compounds (VOC) if applicable < 50 ppm (or PEL per SDS) _________________
[ ] Pass [ ] Fail Ventilation operating and flow direction verified Positive airflow away from entrants _________________
[ ] Pass [ ] Fail Continuous monitoring equipment in place Unit with datalogging and alarms _________________

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Corrective Action Log (Any Failures)

Date / Time Item # Safety Issue Identified Corrective Action Taken Assigned To
___/___/_____ _______ _______________________________ _______________________________ _______
___/___/_____ _______ _______________________________ _______________________________ _______
___/___/_____ _______ _______________________________ _______________________________ _______
Supervisor Sign-Off & Verification

By signing below, the supervisor or designated competent person verifies that all safety checks, atmospheric tests, and compliance audits have been completed according to internal policy and local occupational health laws. Entry is permitted only if all checkboxes are marked PASS.

Supervisor Name / Signature
Date & Time
Permit Valid Until:   Next Test Due:  

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