Hurt & Proffitt | Confined Space Test Form Is the space large enough for a person to bodily enter and perform work? Yes No Does the space have limited or restricted means for entry and exit? Yes No Is the space not designed for continuous occupancy Yes No If any of your answer were NO, this is not a confined space. If all of your answers were YES, then it is a confined space and you need to test to see if it is a Permit Required Confined Space.Could the space contain a hazardous or potentially hazardous atmosphere? (lack of oxygen, carbon monoxide, hydrogen sulfide, flammable gas, etc.) Yes No Does it contain material that has the potential to engulf an entrant? Yes No Does the space have inwardly converging walls that could trap or asphyxiate an entrant? Yes No Does the space contain any physical hazards such as unguarded machinery or exposed wires? Yes No Could the space have any other recognized safety or health hazard? Yes No This is a Permit Required Confined Space.This is a NOT Permit Required Confined Space.If you answer yes to any one of these, then this is a Permit Required Confined Space and you must complete the entry permit and following guidelines for entry. Δ
