Technical Rescuer Confined Space Level II NFPA 1006

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7.2.1 General Skill Requirements JPR #CSII-1 Candidate: : _ Candidate #: STANDARD: 7.2.1 Level II TASK: The candidate shall demonstrate the ability to preplan a, 2013 Edition Confined Space Incident. PERFORMANCE OUTCOME: The student shall preplan a confined space incident, given applicable guidelines and regulations and a preplan form, so that a standard approach is used during a confined space rescue emergency, hazards are recognized and documented, isolation methods are identified and documented, all accesses to the location of the entry opening are identified and documented, all types of entry openings are identified and documented, and internal configurations and special resource needs are documented for future rescuer use. CONDITIONS: Given applicable guidelines and regulations and a preplan form preplan a Confined Space Incident. EQUIPMENT REQUIRED: Guidelines and regulations and a preplan form, pencil. 1. Demonstrate the ability to select a specific preplan form 2. Drafts or draws a sketch of confined spaces 3. Completes supplied forms 4. Identifies and evaluates various configurations of confined spaces, access points, entry openings, isolation procedures, and energy control locations 5. Recognizes general and site-specific hazards 6. Documents all data 7. Applies all regulatory compliance references TOTAL 7.0 Total Points Possible = 7 Total Points Needed To Pass = 5 Total Points d = Proctor/Candidate Comments:

7.2.1 General Skill Requirements JPR # CSII-1

7.2.2 General Skill Requirements JPR #CSII-2 Candidate: : _ Candidate #: STANDARD: 7.2.2 Level I TASK: The candidate shall demonstrate the ability to assess a, 2013 Edition Confined Space Incident. PERFORMANCE OUTCOME: The student shall assess the incident, so that general area and space-specific hazards are identified, bystanders and victims are interviewed, immediate and ongoing monitoring of the space is performed, the victims conditions and location are determined, a risk benefit analysis is performed, methods of ingress and egress for rescuer and victims are identified, rescue systems for victim removal are determined, and an emergency means of retrieval for rescue entrants is established. CONDITIONS: Given a preplan of the space or size-up information, information from technical resources, monitoring equipment, and personal protective equipment required to perform the assessment, assess a Confined Space Incident. EQUIPMENT REQUIRED: Preplan of the space, information from technical resources, monitoring equipment, and personal protective equipment. 1. Demonstrates the ability to select and interpret preplan and size-up information 2. Conducts interviews 3. Chooses and utilizes PPE 4. Operates monitoring equipment 5. Identifies mitigation options 6. Identifies probable victim location 7. Performs risk-benefit analysis 8. Recognizes characteristics and hazards of confined spaces 9. Evaluates specific rescue systems for entry and retrieval of rescuers and victims during confined space incidents TOTAL 9.0 Total Points Possible = 9 Total Points Needed To Pass = 7 Total Points d =

7.2.2 General Skill Requirements JPR #CSII-2 Proctor/Candidate Comments:

7.2.3 General Skill Requirements JPR #CSII-3 Candidate: : _ Candidate #: STANDARD: 7.2.3 Level I TASK: The candidate shall demonstrate the ability to control, 2013 Edition hazards at confined space incident. PERFORMANCE OUTCOME: The student shall control hazards so that the rescue area is established; access to the incident scene is controlled; rescuers are protected from exposure to hazardous materials and atmospheres, all forms of harmful energy releases, and physical hazards; and victims are protected from further harm. CONDITIONS: Control hazards so that the rescue area is established; access to the incident scene is controlled; rescuers are protected from exposure to hazardous materials and atmospheres, all forms of harmful energy releases, and physical hazards; and victims are protected from further harm. EQUIPMENT REQUIRED: PPE and a confined space tool kit, barriers, monitoring equipment. 1. Utilizes personal protective equipment 2. Places scene control barriers 3. Operates atmospheric monitoring equipment 4. Isolates dangerous forms of energy 5. Mitigates physical and atmospheric hazards TOTAL 5.0 Total Points Possible = 5 Total Points Needed To Pass = 4 Total Points d = Proctor/Candidate Comments: