WAYNE BROTHERS COMPANIES.

CONFINED SPACE ENTRY POLICY

This policy defines confined spaces and establishes the health and safety procedures required to be followed up
by all WAYNE BROTHERS employees, subcontractors, or anyone entering a confined space on WAYNE
BROTHERS property or jobsite.
1. DEFINITION - CONFINED SPACE

A confined space has all of the following characteristics:

1. It is large enough that a person can enter and do work, and.....
2. It has limited or restricted means for entry or exit, and.....
3. It is not designed for continuous human occupancy.

Examples of confined spaces on company jobsites or property include:

Pits
Sewers
Trenches
Tanks

2. PERMIT REQUIRED CONFINED SPACES

A permit (EXHIBIT B) is required when the potential for one of the following hazards exists:

• hazardous atmosphere,
• engulfment or entrapment,
• inwardly converging walls or sloping floor, or
• any other serious hazard (electrical, mechanical, hydraulic, etc.)

3. HAZARDS ASSOCIATED WITH CONFINED SPACE ENTRY

• HAZARDOUS ATMOSPHERES -
• Oxygen (O2) levels outside the range of 19.5-23%.
• Flammable or Explosive levels of gases or vapors in excess of 10% of its lower flammable
(LFL) limit.
• Airborne combustible dust at a concentration that meets or exceeds its lower flammable
limit (LFL).
• Toxic substances in dangerous concentration levels.
• ENGULFMENT OR ENTRAPMENT
Contains material (i.e. sand, aggregate, etc.) that has the potential for engulfing an entrant.
• INWARDLY CONVERGING WALLS
Entrant could be trapped or asphyxiated by inwardly converging walls or by a floor, which slopes
downward and tapers to a smaller cross-section.
• ANY OTHER SERIOUS HAZARD

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 Electrical, mechanical, pneumatic, hydraulic, etc. Refer to Lock and Tag Policy.
4. PRE-ENTRY EVALUATION
Before personnel are allowed to enter a confined space, a competent person, generally the
Supervisor, to determine whether or not there is an existing or potential hazard, must evaluate
the space. See EXHIBIT A. This will be accomplished by:

(1) Use atmospheric testing results to determine if a hazardous atmosphere exists (O2,
flammable, toxic, and dust). If a hazardous atmosphere exists, has the space been
ventilated and retested or has the entering employee been provided with the appropriate
respirator? Refer to Respirator Program.

(2) Are engulfment or entrapment hazards in the space?

(3) Do walls of the space converge to a small area or are the floors sloping?

(4) Are any other serious hazards within the space such as electrical or mechanical hazards?
If so, have Lock and Tag procedures been completed?

(5) Are additional hazards to be introduced into the space, such as welding fumes or cleaning
solvents? If so, have adequate precautions been taken to make the atmosphere safe? If
not, is appropriate respiratory equipment used? Refer to Respirator Program.

5. ENTRY PERMIT
EXHIBIT B to this policy contains a Confined Space Entry Permit Form. This permit must be
completed and signed by the Supervisor before any employee enters the confined space,
unless it has been determined through the pre-entry checklist (EXHIBIT A) that no hazard
exists or through alternate procedures (EXHIBIT B) that the atmosphere is safe.

6. ENVIRONMENTAL MONITORING
Monitoring performed prior to entry shall be conducted as follows:

(1) Conduct the initial monitoring without entering the confined space.

(2) Readings must be taken at various locations (levels) within the confined space.

(3) Testing should be done in the following order, using instruments that are calibrated at
intervals recommended by:
A) Percentage of oxygen (O2) must be within 19.5-23%.
B) Presence of flammable gases or vapors, or combustible solids (dusts). Need to know
specific fuel if reading is above 0%.
C) Concentration of known toxic substances. Example:
(1) Hydrogen Sulfide (H2S): 10 PPM or less.
(2) Carbon Monoxide (CO): 35 PPM or less.

Suggested time requirements for testing at each location/level are 30 seconds or per the
specifications for response time for the instrument being used.
(4) If any of the ranges fall outside the ranges in (3) above, employees must not enter the
confined space or must leave it immediately.

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 (5) If a confined space must be exited, the Supervisor will evaluate whether re-entry is
possible using additional safeguards.

7. RESCUE PROCEDURES
Rescue procedures must be defined prior to allowing entry into any confined space.
Appropriate actions could include:

(1) Ensure that appropriate rescue equipment (i.e. self-contained breathing apparatus,
harness/lifeline, flashlight, etc.) is present at the entrance of the confined space or would
be immediately available for a rescue team.

(2) Either train employees in proper rescue procedures or assure community rescue services
area available. Means should be assured for prompt communication to either the company
or community rescue team.

(3) Employees entering the space wearing safety harnesses attached to lifeline should have a
secure “tie-off”.

(4) If safety harnesses and lifelines are not feasible, determine alternative rescue equipment
prior to entry into the confined space.

8. ATTENDANTS
A standby person should be assigned to remain on the outside of the confined space and be
in constant contact (visual or speech) with the workers inside. The standby person should not
have any other duties but to serve as a standby and trained to summon emergency rescue
assistance (loud horn, radio, mobile phone, or other method). Under no circumstances should
the attendant enter the confined space. After help arrives, if the attendant has proper
equipment then he/she can assist with rescue.

The attendant must be trained in rescue procedures prior to entering.

9. SAFE WORK PRACTICES - CONTROL MEASURES

A. Cleaning, purging, and ventilation may be necessary to maintain a safe atmosphere.

B. Lock and Tag/tag out of all energy sources to ensure a zero energy state in the confined
space. Refer to Lock and Tag/Tag out Policy.

C. Isolation of all chemical or material lines providing solids, liquids, or gases to the confined
space.

D. A safe means of entry and exit must be provided. Ladders should be used when normal
access/egress cannot be made. Bosum chains or winch devices are preferred if depth is
greater than 5 feet.

E. The confined space will be barricaded to prevent persons or objects from either falling into
(i.e. manhole) or jeopardizing the safety of the process.

F. A sign with similar wording of “Confined Space. Do Not Enter” shall be posted.

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 G. Ground fault circuit interruption (G.F.C.I.) shall be provided when using electrical tools or
equipment. Only grounded or double insulated tools will be used.

H. The Supervisor, working with the Project Manager, will provide all subcontractors with
information about confined spaces on our jobsites or property.

I. The Supervisor, working with the Project Manager will assure that subcontractors or
vendors performing work within a confined space on our jobsites or property are using
permits and taking adequate precautions.

10. TRAINING
All employees/supervisors involved in confined space entry will be provided information and
training. It will be the responsibility of each Supervisor to assure all employees are trained
before entering a confined space. This includes attendants, rescue persons, and everyone
else supporting the entry process.

11. RESPONSIBILITY
It shall be the responsibility of the immediate Supervisor to assure compliance with this policy
on all Company jobsites or property.

The Project Managers and all Supervisors have been expressly authorized to halt any
operation of the company where there is a danger of serious personal injury. This policy
includes confined space hazards.

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 EXHIBIT A
PRE-ENTRY CHECKLIST

Jobsite Name, Date and Time:

Job To Be Performed:

PRE-ENTRY:
1. Atmospheric Checks: Time
CO
H2S
O2 %
LEL

2. Source Isolation (No Entry): N/A YES NO

Pumps, or lines blinded ( ) ( ) ( )
Disconnected, or blocked ( ) ( ) ( )

3. Ventilation: N/A YES NO

Mechanical ( ) ( ) ( )
Natural Ventilation Only ( ) ( ) ( )

4. Atmospheric check after isolation and ventilation:

Time
CO
H2S
O2 %
LEL

N/A YES NO
5. Engulfment or Entrapment Hazards? ( ) ( ) ( )

6. Walls of the space converge to a small

area or floor sloping? ( ) ( ) ( )

7. Other Hazards?
(Electrical, Mechanical, Pneumatic)? ( ) ( ) ( )

8. Additional Hazards to be Introduced?

(Welding Fumes, Cleaning Solvents, etc) ( ) ( ) ( )

If conditions are in compliance with above requirements and there is no reason to believe conditions may
change adversely, then proceed to enter the space without a permit (Harness and Lifeline at depth of 5ft or
more).
If conditions are not in compliance with above requirements or there is reason to believe that conditions may
change adversely proceed to Permit Form (EXHIBIT B).
Checklist Prepared By: Supervisor
Approved By (Safety Director)
This checklist is to be kept at jobsite.

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 EXHIBIT B

ENTRY PERMIT
CONFINED SPACE HAZARDOUS AREA PERMIT NO.
• PERMIT VALID FOR EIGHT HOURS ONLY • ALL COPIES OF PERMIT WILL REMAIN AT JOB SITE UNTIL JOB IS COMPLETED

SITE LOCATION/DESCRIPTION
PURPOSE OF ENTRY
DATE PERMIT EXPIRATION DATE/TIME
SUPERVISOR(S) IN CHARGE OF CREWS TYPE OF CREW PHONE NO.

REQUIREMENTS TO BE COMPLETED PRIOR TO ENTRY (Bold denotes minimum requirements to be completed and reviewed
prior to entry
COMPLETED COMPLETED
ENTER N/A FOR ITEMS THAT DO NOT APPLY DATE TIME DATE TIME
Lock Out / De-Energize / Try-Out Lifelines
Line(s) Broken - Capped - Blanket Resuscitator - Inhalator
Purge - Flush and Vent Standby Safety Personnel
Ventilation Full Body Harness (with “D” ring)
Breathing Apparatus Fire Extinguishers
Emergency Escape Retrieval Equipment Lighting (explosive proof)
Communication Device(s) Protective Clothing
Atmosphere Monitoring Device(s) Respirator(s) (air purifying)
Secure Area (pose and flag) Burning and Welding Permit

CONTINUOUS MONITORING (record results every 2 hours)

TESTS TO BE TAKEN PERMISSIBLE ENTRY LEVEL MONITORING RESULTS
AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM
Percent of Oxygen 19.5%-23.5%
Lower Flammable Limit Under 10%
Carbon Monoxide <35 PPM
Methane +1 PPM *5 PPM
Hydrogen Sulfide +10 PPM *15 PPM
Sulfur Dioxide +2 PPM *5 PPM

Other

*Short-term exposure limit: Employee can work in the area up to 15 minutes

+ 8 hour time-weighted average: Employee can work in the area 8 hours (longer with appropriate respiratory protection)
REMARKS

GAS TESTER NAME & CHECK NO. INSTRUMENT(S) USED MODEL AND/OR TYPE SERIAL AND/OR UNIT NO.

RESCUE PROCEDURE

ADDITIONAL INFORMATION EMERGENCY PHONE NUMBERS

Ambulance Safety
Fire Rescue
Gas Coordinator

PERMIT AUTHORIZATION (pink copy to Safety) REQUIRED SAFETY CHECK AUTHORIZED CHECK
I certify that all required precautions have been taken and STANDBY PERSON(S) NO. ENTRANTS NO.
necessary equipment is provided for safe entry and work in this
space.

NAME (print) DATE

SIGNATURE
DEPARTMENT PHONE NO

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 WAYNE BROTHERS, INC.
CONFINED SPACE TRAINING ACKNOWLEDGMENT

I acknowledge that I have attended a training session on confined spaces procedures and
understand the following control plan:
1. Confined Space - Definition.
2. Confined Space - Hazard.
3. Permit Required.
4. Alternate Procedures.
5. Pre-Entry Evaluation.
6. Entry Requirements.
7. Rescue Procedures.
8. Attendants Role.
8. Safe Work Practices.
10. Responsibility and Training.

In addition I understand and have been trained in the following:

1. How to identify confined spaces on jobsites and fixed locations.
2. How to determine if space is permit or non-permit.
3. How to ensure space is safe during the entire work process.

__________________________________________ ______________________
Instructor Name Date

Employee Names Employee Names