Scope_of_Work.doc

Confined Space Inventory Project Scope

1. Project Location

The project is located forest wide on the San Juan National Forest (SJNF). The SJNF is located in the southwest corner of Colorado and is comprised of the Columbine Ranger District, Dolores Ranger District, and the Pagosa Ranger District; and extends from Wolf Creek Pass near Pagosa Springs, Colorado to Lizard Head Pass near Rico, Colorado.

2. Project Description

The purpose of this project is to start implementation of the Confined Space Plan through inventory and documentation of confined space within the San Juan National Forest. Confined space types include water tanks, spring boxes, sewer opening, septic tanks, basements, crawl spaces and attics. The type and quantity of known confined spaces are listed in Attachment A.

3. Project Scope The inventory and implementation shall be addressed by each confined space. The scope of the Confined Space Inventory project is addressed in the following.

1. All water tanks, spring boxes, sewer opening, septic tanks, basements, crawl spaces and attics identified in Attachment A shall be inventoried.

2. Inventorying of sites shall consist of completion of the inventory form given in Attachment B. This includes, but is not limited to, site classification, dimensions/size of confined space, air quality measurements, photos, a brief description of the site and its uses, etc.

3. A gas detector shall be provided by the San Juan National Forest for use by the contractor to record concentrations of for of O2, CO, H2S, and percent of Lower Explosive Limit (LEL) for flammable gasses.

4. Inventorying of sites shall also include input of sections 1,3,4,5,7,9, and 10 of the permit to entry form for all permit required confined spaces given in Attachment C. Communications with Forest Service personnel may be necessary to sufficiently inventory the sites.

5. All inventoried confined spaces shall be signed in accordance with the determined classification following approval by the CO. The signing shall be one (1) of the three (3) wordings depending on its declared classification: Confined Space No Entry, Confined Space, or Confined Space Permit Entry Only. Signs shall be affixed to the access door or man way of each confined space.

6. Notify the COR of any confined spaces identified through field investigations that are not included on Attachment B.

7. Access to most confined spaces shall be via a standard SJNF key.

8. Contractor shall provide two hard (2) copies and one (1) electronic copy of the inventory to Kamber Hurst, EIT at Public Land Office, 15 Burnett Court, Durango, Colorado 81301.

9. Payments will be made in accordance with pay items in the Schedule of Items.

4. Definition of a Confined Space a.

A confined space has limited or restricted means of entry or exit, is large enough for an employee to enter and perform assigned work, and is not designed for continuous occupancy by the employee. These spaces may include, but are not limited to, underground vaults, tanks, storage bins, pits and diked areas, manholes, cisterns, vessels, and silos.

b.

A permit required confined space (i.e., permit space) refers to those spaces that meet the definition of a “confined space” and pose health or safety hazards, thereby requiring a permit for entry.

c.

A certificate-required confined space (i.e., certificate space) refers to those permit-required confined spaces determined to present an actual or potentially hazardous atmosphere which requires continuous forced-air ventilation.

5. Classification of a Confined Space a.

Permit-Required Confined Space: If the hazards the space poses are unknown and/or entry is required to evaluate the space for hazards, the space must initially be classified as a permit-required confined space. During entry, testing and inspection should provide the data necessary to properly classify the space. If the space has any one of the following characteristics (hazards) it must be classified as a Permit-Required Confined Space.

(1) Contains a material that has the potential for engulfing an entrant.

(2) Has an internal configuration such that an entrant could be trapped or asphyxiated by inwardly converging walls or by a floor which slopes downward and tapers to a smaller cross-section.

(3)

Contains any condition that poses an immediate or delayed threat to life, would cause irreversible adverse health effects, or would interfere with an individual’s ability to escape unaided (self- rescue) from a confined space.

(4)

Contains an atmosphere not controllable by forced air ventilation alone that may expose employees to the risk of death, incapacitation, impairment of ability to self-rescue, injury, or acute illness. The following are considered hazardous atmospheres:

(a)

Flammable gas, vapor, or mist in excess of 10% of its Lower Flammable Limit (LFL).

(b) Airborne combustible dust at a concentration that meets ‘or exceeds its LFL (A condition in which dust obscures vision within 5 feet - approximately).

(c) Atmospheric oxygen concentration below 19.5% or above 23.5%.

(d) Atmospheric concentration of any substance which could result in employee exposure in excess of its dose or permissible exposure limit (PEL)

(5) Contains any other recognized serious safety or health hazard.

(6)

All sewer openings are considered Permit-Required Confined Space.

b.

Non-Permit/Certificate Required Confined Space (C7): This classification may be used if the space does not contain or, with respect to atmospheric hazards, have the potential to contain any hazard capable of causing death or physical harm. Additionally (not just controlled), this classification may be used if all the hazards in the space can be eliminated. If the space has been classified as a non-permit/certificate space then the unit has met the requirements of this program as it pertains to this individual space. Entry may proceed without following the permit or certificate requirements of this program. However, the space may only be classified as a Non-Permit/Certificate Space as long as no hazards exist c.

Alternative Procedure/Certificate-Required Confined Space (C5): This classification may be used if the ONLY hazard posed by confined space, or by the work conducted in the space, is an actual or a potentially hazardous atmosphere AND that hazardous atmosphere can be reduced to safe entry levels by forced air ventilation alone. When entering these spaces, continuous forced air ventilation is required. This space may only be classified as a certificate space as long as no other hazards arise. If other hazards arise, or there are changes in the use or configuration of the space that might increase the hazards to entrants, the unit shall re-evaluate the space and, if necessary, reclassify it.

d.

Hazardous Non-Entry: A Hazardous Non-entry space is a Permit or Certificate space which the unit has determined will not be entered by employees. (See Permit/Certificate Space Entry Determination) Attachment A:

Table 1: Proposed Quantity of Confined Spaces Signs

Table 2: Sites on the SJNF where confined spaces are located

Bayfield Office Complex

Rico GS

Chris Park CG

Aspen GS

East Animas WC

Cabin Canyon CG

Engineer Mountain GS

Cayton CG

Graham Creek CG

Dolores Office Complex

Haviland Lake CG - Active

Dry Canyon CG

Junction Creek CG

Dunton GS

Middle Mountain CG

Ferris CG

Miller Creek CG

House Creek CG

Pine Point CG

Mavresso CG

Snow Slide CG

McPhee Rec.

South Mineral CG

Rico GS

Transfer Park CG

Sage Hen

Trimble WC

Target Tree CG

Vallecito CG

West Dolores CG

Vallecito WC

Pagosa Job Corps

Palisades Horse CG

Ute CG

Williams Creek CG

Table 3: Sites per District

Table 4: Detailed List of Confined Spaces

Attachment B

Site Name:I (From INFRA) Forest:

District:

Baseline Assessment Date:

(MM/DD/YYYY)

I. SPACE LOCATION

A. Site ID #:

(From INFRA) B. Building or System ID #:

(From INFRA)

C. Description of Site:

D. Dimensions Measure or Estimate the Space Dimensions: For calculating purge/ventilation time

1. Circular: (3.14) x R 0.0

= FORMTEXT

2 x H

0.00 Cu Ft.

2. Square or Rectangle: L 0 x H FORMTEXT x W

0.00 Cu Ft.

E. Description of Workspace:

1. No. of Entry Points:

2. Entry Method (Ladder, Built in Rugs):

3. Frequency of Entry:

4. Orientation of Space: (Check one) FORMCHECKBOX Vertical= Entry to Bottom FORMCHECKBOX Horizontal= Entry to Distant Point

F. Reason to Enter Space:

II. SPACE ASSESSMENT Check the appropriate answer to each question. This is only a preliminary investigation, and spaces may be re-classified.

A. Confined Space

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

B. Permit-Required Confined Space

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Yes

FORMCHECKBOX

No

Is the space a Permit-Required Confined Space? (If you answered “yes” to any of the above questions, the space is a permit-required space.)

FORMCHECKBOX

Yes

FORMCHECKBOX

No

*IDLH= Immediate Danger Life or Health

III. Space Type Check the category that best describes the place.

1. Aircraft

a. FORMCHECKBOX Tank

b. FORMCHECKBOX Bilge

c. FORMCHECKBOX Trail Section

d. FORMCHECKBOX Turbine Case

e. FORMCHECKBOX Other (list)

3. Crawlspace (list type) Once entered is difficult to exit

5. HVAC

a. FORMCHECKBOX Duct

b. FORMCHECKBOX Fan

c. FORMCHECKBOX Plenum

d. FORMCHECKBOX

7.Mechanical Equipment

2. Bilk Tankers

Water Trailers

b. FORMCHECKBOX Water Trucks

c. FORMCHECKBOX Other (list)

4. Dams

a. FORMCHECKBOX Tunnel

b. FORMCHECKBOX Hazardous Material

c. FORMCHECKBOX Water

d. FORMCHECKBOX Shaft

e. FORMCHECKBOX

6. Excavation/Trench “permanent location

8. Manhole

Communications

b. FORMCHECKBOX Electrical

c. FORMCHECKBOX Lift Station

d. FORMCHECKBOX Potable Water

e. FORMCHECKBOX Sanitary Sewer

Site ID #:

Building or System ID:

III. Space Type (continued)

9. Pipelines

a. FORMCHECKBOX Water

b. FORMCHECKBOX

11. Sumps

13. Tanks (AST= Above Ground and UST= Underground)

Aeration

b. FORMCHECKBOX Fuel (AST)

c. FORMCHECKBOX Fuel (UST)

d. FORMCHECKBOX Septic

e. FORMCHECKBOX Water (AST)

f. FORMCHECKBOX Water (UST)

g. FORMCHECKBOX Other (list)

14. Vaults

a. FORMCHECKBOX Chlorine

b. FORMCHECKBOX Meter/Valve

c. FORMCHECKBOX Power

d. FORMCHECKBOX Other (list)

10. Pits

a. FORMCHECKBOX Elevator Shaft

b. FORMCHECKBOX Sewage

c. FORMCHECKBOX Meter/ Valve

d. FORMCHECKBOX Water

e. FORMCHECKBOX Other (list)

12. Wells

a. FORMCHECKBOX Water

b. FORMCHECKBOX

15. Others (list)

IV. Space Hazards

Using professional judgment, determine if the following hazards currently exist or may potentially exist in the space. Check the appropriate box for each hazard. (Yes, No or Potentially)

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

Yes

FORMCHECKBOX

No

FORMCHECKBOX

Pot.

V. Air Monitoring Readings

(at 4’ intervals)

(take average every 20 min. unless specified)

Other:

Time (hh:mm)

Initial

FORMCHECKBOX

Bump Test this entry

VI. SIGNATURE BLOCK

Site ID #:

Building or System ID #:

MACROBUTTON InsertPicture

MACROBUTTON InsertPicture [Unlock Forms, then Click here to insert Photos or Images.]

AUTHORIZED PERSONNEL

Personnel who are trained and authorized to function in Permit – Required Confined Space roles as described in this document.

1.

Entrant Name(s) (individual actually entering confined space): _________________

2.

Attendant(s): _________________________________________________________

3.

Confined Space Entry Supervisor(s): ______________________________________

Attachment C

Confined Space Entry Program – Appendix H

CONFINED SPACE ENTRY PERMIT/CERTIFICATE

SEE REVERSE FOR DESCRIPTIONS AND PROCEDURES

1. FORMCHECKBOX

This is a “Permit-Requined” confined space entry.

FORMCHECKBOX

This is a CERTIFICATE for an “Alternate Procedure” confined space entry.

FORMCHECKBOX

This is a CERTIFICATE for a “Non-Permit-Required” confined space entry.

2. General Information Confined Space #/Location:

Date Issued: Time Issued: Time Permit Expires:

Purpose of Entry:

3. List hazard(s) associated with this entry:

4. Preparation FORMCHECKBOX Drained FORMCHECKBOX Flushed FORMCHECKBOX Inserted

FORMCHECKBOX

Purged FORMCHECKBOX Ventilated FORMCHECKBOX Other Openings: FORMCHECKBOX Barricaded FORMCHECKBOX Guarded FORMCHECKBOX Flagged Specify Procedures:

5. Isolation Equipment: FORMCHECKBOX Locked out/Tagged FORMCHECKBOX Other:

Lines: FORMCHECKBOX Disconnected FORMCHECKBOX Blanked FORMCHECKBOX Other:

Specify Procedures:

6. Communications Procedures at confined space:

FORMCHECKBOX

Voice FORMCHECKBOX Radio FORMCHECKBOX Intercom FORMCHECKBOX Rope Signals

7. Other Required Permissions (e.g., Hot Work Permit):

8. SPECIFY METHOD FOR CONTACTING EMERGENCY / SERVICE / RESCUE PERSONNEL:

FORMCHECKBOX

System Check was Completed Initials:

9. Identify Special equipment required: FORMCHECKBOX Safety harness/ lifeline (if < 5’) FORMCHECKBOX Hoist FORMCHECKBOX Other (specify):

10. Specify Required Protective Equipment (PPE): Eye protection:

Head protection: Ear protection: Foot protection:

Gloves: Respirator (type/cartridge used):

Protective clothing: Other:

Entry Supervisor:

Entry Approved –

Initial:

Entry Terminated –

Initial:

Permit Transferred –

Initial:

Attendant:

Entrant:

Entrant:

FORMCHECKBOX

Additional sampling results attached

Conditions Pre-Entry Check

(at 4’ intervals)

(take average every 20 min. unless specified)

other:

Time

Post this Permit at job site. After exit: file original in Safety Manager’s office; file copy in entrant’s personnel file.

13. ENTRANT ENTRY/EXIT LOG FORMCHECKBOX

ADDITIONAL ENTRY/EXIT LOG(S) USED AND ATTACHED

NAME

TIME IN

TIME OUT

TIME IN

TIME OUT

14. Notes and Additional Comments / Problems during entry:

Entering a Permit-Required Confined Space

1. The Entry Supervisor physically inspects the space to determine potential hazards and if the entry is a “Permit-Required,” “Alternate Procedure,” or “Non-Permit” entry. Entry Supervisor then completes all items on this Confined Space Entry Permit.

2. At least one Attendant externally monitors the Permit Space being entered for the duration of the entry operation.

3. Maintain retrieval equipment and use all safety equipment as specified on the permit.

4. Attendant verifies acceptable entry conditions by identifying, and controlling or eliminating, any hazards; by testing the atmosphere with an oxygen / gas detector at 4 foot intervals, and a PID if organic vapors are detected or expected, and other appropriate testing equipment for other known or expected contaminants; and by complying with all entry permit conditions.

5. Attendant directs the Entrant(s) to enter and exit the space, and conducts periodic checks of hazard controls.

6. Attendant orders immediate evacuation of the space if safety equipment fails or if the space becomes, or has the potential to become, immediately hazardous. If necessary, Attendant summons emergency responders, but NEVER ENTERS space.

7. When confined space operation is complete, Entry Supervisor accounts for all Entrants, & terminates entry by initialing in Section 11.

Entering a Permit Confined Space using “Alternate Procedure”

A. This Alternate Entry Procedure may be used if the only hazard present in the confined space (as determined by Entry Supervisor) is: 1) Atmospheric in nature,and 2) The Atmospheric Hazard can be controlled by mechanical ventilation alone, and if 3) The Permit Space atmosphere will not become immediately dangerous to life and health (IDLH) if the mechanical ventilation fails.

B. After evaluating the “Permit Required Confined Space,” and establishing appropriate atmospheric controls, the Entry Supervisor may classify the Permit Space as an Alternate Entry Space by checking the appropriate box in Section #1 of the Confined Space Entry Permit, and completing applicable parts of “Sections 2, 3, 4, 5, 8, 9, 10, 11, 12, and 13” of the Entry Permit.

C. The Entrant (see note below) may enter the confined space without the assistance or use of an

Attendant, following below procedure.

D. When entering the Alternate Entry Confined Space, the Entrant will:

1. Establish and ensure that the mechanical ventilation system is operational and providing clean, fresh air to the Entrants work location within the space during the entire entry;

2. Test the atmosphere of the Permit Space prior to entry into the space;

3. Use and continually operate a personal gas detector during the entire confined space operation;

4. Immediately evacuate the space if ventilation fails, or if the portable air sampling equipment fails or enters alarm mode; and

5. Immediately evacuate the space if you discover, or become aware of a previously unrecognized hazard. If this occurs, immediately notify the Entry Supervisor (or Entrant’s line supervisor, if Entrant is also Entry Supervisor). The Entry Supervisor re-evaluates the Permit Space and implements appropriate safety precautions prior to resuming the confined space operation.

Note: Entry Supervisor may act as Entrant during Alternate Entry Confined Space operations. No Attendant is necessary for Alternate Procedure entries, unless assistance is needed to accomplish safe entry and exit by the Entrants (i.e., a tripod to enter a tank, etc.).

E. All steps taken to reclassify the Permit Space to an Alternate Entry Space must be written on the entry permit. All confined spaces shall be considered Permit-Required until the pre-entry procedures demonstrate otherwise.

Entering a Non-Permit Confined Space A. If no inherent hazard is associated with the space, or if all inherent hazards have been

“ELIMINATED” (not just controlled, but eliminated), the space may be entered using the following guidelines.

B. When entering the Non-Permit Confined Space, the Entrant(s) will:

1. Survey the surrounding area for potential hazards and sources of drifting vapors and gases before entry;

2. Always test a Non-Permit Confined Space with an oxygen/explosive gas detector before and during entry; document pre-entry tests;

3. Follow USC safety rules and use generally acceptable safe work practices when entering and working in the space;

4. Never use paints, thinners, chemicals, or weld or create any other atmospheric hazard while working in the space;

5. Never introduce any other atmospheric, mechanical, engulfing, or electrical hazard into the space.

Note:

Introduction of a hazard (e.g., paint thinner) into a confined space requires that the full permit process be followed.

C. No attendant or arrangement for rescue service is necessary when workers enter Non-Permit Spaces.

D. All steps taken to reclassify a Permit-Required Space to a Non-Permit-Required Space must be written on the entry permit.