Hurt & Proffitt | Confined Space Test Form

    Is the space large enough for a person to bodily enter and perform work? YesNo

    Does the space have limited or restricted means for entry and exit? YesNo

    Is the space not designed for continuous occupancy? YesNo

    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.) YesNo

    Does it contain material that has the potential to engulf an entrant? YesNo

    Does the space have inwardly converging walls that could trap or asphyxiate an entrant? YesNo

    Does the space contain any physical hazards such as unguarded machinery or exposed wires? YesNo

    Could the space have any other recognized safety or health hazard? YesNo

    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.