Confined Space Identification & Hazard Assessment SECTION 1: SPACE LOCATION DETAILS NAME / TYPE OF SPACE: Lyndhurst Elementary / Crawl Space SPACE CLASS: 1L LOCATION OF SPACE: Under North West wing of school SPACE # 036 1 DATE OF ASSESSMENT: July 17/2012 ASSESSMENT #: 20120717 1 SECTION 2: SPACE DETERMINATION Yes No COMMENTS 1 Enclosed or partially enclosed? This crawl space can be The space is NOT designed or intended for continuous human 2 occupancy? 3 4 Does the space have limited or restricted means for entry or exit that may complicate the provision of first aid, rescue or other response service? Is the space large enough and so configured that a worker could enter to perform assigned work? SPACE IS A CONFINED SPACE PER WSBC PART 9.1 DESCRIPTION OF SPACE SECTION 3: SPACE CHARACTERISTICS entered thru a floor hatch with an immediate 36 drop onto a sand floor. Unable to verify that venting will provide continuous passive ventilation to the entire space. DESCRIPTION OF ENTRY / EGRESS POINTS Entry Point #1 # OF ENTRY POINTS 1 Notes: Access is via a 29 x32 floor hatch located inside HEIGHT: Average 3 high. room #213. WIDTH: Approx 30 LENGTH: Approx 132 VOLUME: Approx 11 880 c GENERAL SHAPE: USE / FUNCTION: INTERNAL MACHINERY: Rectangular Crawl Space / foundation No ADJACENT PIPING: No ELECTRICAL: Yes INTERNAL SPACES WITHIN: No Entry Point #1 #101 3727 2 nd Ave, Burnaby, BC, V5C 3W6 ~ 1 ~ E mail: sales@envirosafety.ca www.envirosafety.ca
SECTION 4: PRE EXISTING CONDITIONS CATEGORY POTENTIAL PRESENCE RISK LEVEL Yes No L M H ATMOSPHERIC S 1 OXYGEN DEFICIENCY (<19.5%) OXYGEN ENRICHMENT (>23.0%) FIRE / EXPLOSIVE GASES / VAPOURS HYDROGEN SULFIDE CARBON MONOXIDE AMMONIA CHLORINE ORGANIC VAPOURS CRISTALLINE SILICA ASBESTOS Sand floor can be subject to underground natural gas pipeline leaks or underground natural methane build up into the space. There are several holes drilled through the concrete foundation walls for pipe and supports. There are several potential areas for silica dust remnants to be present. There is no visual evidence of asbestos, however, due to the year the school was built, there is a possibility that materials containing asbestos were used. ATMOSPHERIC TEST LEVEL AT THE TIME OF THE ASSESSMENT: RESULT Top Middle Bottom OXYGEN % Vol 20.9% 20.9% 20.9% Space was tested and found % LEL 0% LEL 0% LEL 0% LEL to have adequate Oxygen, no CARBON MONOXIDE PPM 0 PPM 0 PPM 0 PPM flammable, no CO and no HYDROGEN SULFIDE PPM 0 PPM 0 PPM 0 PPM H2S gasses. #101 3727 2 nd Ave, Burnaby, BC, V5C 3W6 ~ 2 ~ E mail: sales@envirosafety.ca www.envirosafety.ca
CATEGORY CHEMICAL S SECTION 4: PRE EXISTING CONDITIONS (continued) POTENTIAL PRESENCE RISK LEVEL Yes No L M H 2 CONTROLLED PRODUCTS 3 INGESTION/SKIN CONTACT 4 CHEMICAL REACTIVITY 5 CHEMICAL RESIDUAL/SLUDGE BIOLOGICAL S PHYSICAL AGENTS PHYSICAL CONFIGURATION 6 MOULD / BACTERIA 7 SEWAGE (HUMAN ORGANIC MATTER) 8 ANIMAL ORGANIC MATTER 9 NOISE / VIBRATION 10 HEAT / COLD STRESS 11 NON IONIZING RADIATION 12 IONIZING RADIATION 13 STRUCTURAL 14 PERSONAL CONFINEMENT 15 FLOOR OPENINGS 16 CONVOLUTED SPACE No evidence of mould within the space at the time of the assessment. There are drain/sewer lines within the space which if ruptured would accumulate sewage inside the space. There was no evidence of sewage inside the space at the time of the assessment. No evidence of animal organic matter within the space at the time of the assessment. There are several areas inside the space where it is necessary to pass between pipes which can create confinement hazards. 3 drop into space. There are no internal floor openings. PHYSICAL S 17 OVERHEAD Several areas where ready rod is used to hold up pipes which can 18 SHARP EDGES pose an overhead puncture hazard or a sharp point. 19 MECHANICAL 20 ELECTRICAL Typical building wiring. 21 HYDRAULIC 22 PNEUMATIC 23 ADJACENT PIPING / PROCESS LINES #101 3727 2 nd Ave, Burnaby, BC, V5C 3W6 ~ 3 ~ E mail: sales@envirosafety.ca www.envirosafety.ca
SECTION 4: PRE EXISTING CONDITIONS (continued) CATEGORY PHYSICAL S (Continued) POTENTIAL PRESENCE RISK LEVEL Yes No L M H 24 LIQUID / WATER ACCUMULATION 25 FLOODING 26 ENGULFMENT /BRIDGED MATERIALS 27 ENTRAPMENT/ENTANGLEMENT 28 FALL 29 ENTRY / EXIT 30 HOT / COLD WORKING SURFACES 31 SHARPS (NEEDLES / SYRINGES) 32 VEHICLE TRAFFIC/MOVING EQUIPMENT 33 WORKER / PUBLIC INTERFERENCE 34 ANIMAL INTERACTION The space is below grade so there is a potential for rain/ground water accumulation or a water pipe rupture. An immediate 3 drop into the space. There are no other fall hazards once inside the space. There are hot water heating pipes in which exposed areas will be hot when boiler/heating system is operational. Venting is large enough to allow small rodents to enter the space. There was no evidence that rodents or animals have been inside the space at the time of the assessment. SAFETY S 35 VISIBILITY / LIGHT LEVEL 36 COMMUNICATION 37 ERGONOMIC 38 SLIP / TRIP 39 WEATHER CONDITIONS There is lighting within some areas of the space. Due to the size and configuration, verbal communication is not possible from many inside areas to the exterior of the space. Travel inside the space is on hands and knees or by belly crawling under obstructions making for uncomfortable access. There is a potential trip hazard while entering and exiting the space but it is unlikely once inside the space. #101 3727 2 nd Ave, Burnaby, BC, V5C 3W6 ~ 4 ~ E mail: sales@envirosafety.ca www.envirosafety.ca
SECTION 5: SPACE CLASSIFICATION BASED ASSESSMENT Low Mod High BASIS FOR DESCISON ATMOSPHERIC CLASS Based on gas testing there is good clean respirable air inside the space at the time of assessment and based on viewing all areas of the internal workings of the space it is unlikely it will change without something being introduced into the space. ASSESSOR / QUALIFIED PERSON SECTION 9: SIGN OFF & ACCEPTANCE ASSESSOR / QUALIFIED PERSON REVIEWER / QUALIFIED PERSON ACCEPTED BY BURNABY SCHOOL DIST. 41 DESIGNATE NAME: Steve Johnson Jereld Salazar, BSc, CRSP Mike Orchison Terry Gomez TITLE: OH&S Specialist OH&S Specialist OH&S Specialist Health & Safety Officer SIGNATURE: DATE: July 17/2012 July 17/2012 July 17/2012 SECTION 10: DISCLAIMER This space identification and initial hazard was completed after entry and inspection from inside the space. It provides an initial hazard assessment and has NOT taken into consideration any work activity which may be required inside the space. This assessment must be combined with a hazard assessment which has been done for a specific activity within a particular space or group of similar spaces at which point it may provide the basis for procedures for every occasion when workers enter those spaces. On each such occasion, the circumstances of the proposed job should be considered beforehand by the supervisor (who need not be a "qualified person" under section 9.11) to ensure that the criteria or conditions upon which the hazard assessment is based remain substantially the same. If the conditions are different in a way that might affect the outcome of the hazard assessment previously done by a qualified person, then the circumstances should be reviewed and entry procedures revised as necessary, by a "qualified person". The assessment of a "qualified person" cannot be changed without the concurrence of the same or another "qualified person". #101 3727 2 nd Ave, Burnaby, BC, V5C 3W6 ~ 5 ~ E mail: sales@envirosafety.ca www.envirosafety.ca
PICTURES FROM INSIDE THE SPACE Envirosafety Confined Space Safety Equipment Inc. nd #101 3727 2 Ave, Burnaby, BC, V5C 3W6 Phone: 604 298 7777 ~6~ E mail: sales@envirosafety.ca Fax: 604 298 7789 www.envirosafety.ca