This confined space rescue plan template outlines the procedures and equipment for rescuing entrants from a specific confined space. It identifies the confined space location, whether inerting or purging gases are used, and the entry watch and on-site or off-site rescue services. Communication methods between the safety watch, entrants, and person in charge are specified. The template also requires identifying rescue methods, any necessary rigging, breathing equipment, gas testers, standby attendants, rescue equipment, medical supplies, and additional personal protective equipment.
This confined space rescue plan template outlines the procedures and equipment for rescuing entrants from a specific confined space. It identifies the confined space location, whether inerting or purging gases are used, and the entry watch and on-site or off-site rescue services. Communication methods between the safety watch, entrants, and person in charge are specified. The template also requires identifying rescue methods, any necessary rigging, breathing equipment, gas testers, standby attendants, rescue equipment, medical supplies, and additional personal protective equipment.
This confined space rescue plan template outlines the procedures and equipment for rescuing entrants from a specific confined space. It identifies the confined space location, whether inerting or purging gases are used, and the entry watch and on-site or off-site rescue services. Communication methods between the safety watch, entrants, and person in charge are specified. The template also requires identifying rescue methods, any necessary rigging, breathing equipment, gas testers, standby attendants, rescue equipment, medical supplies, and additional personal protective equipment.
This confined space rescue plan template outlines the procedures and equipment for rescuing entrants from a specific confined space. It identifies the confined space location, whether inerting or purging gases are used, and the entry watch and on-site or off-site rescue services. Communication methods between the safety watch, entrants, and person in charge are specified. The template also requires identifying rescue methods, any necessary rigging, breathing equipment, gas testers, standby attendants, rescue equipment, medical supplies, and additional personal protective equipment.
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CONFINED SPACE RESCUE PLAN (template)
Confined Space Name/Location: Identification #: Date:
Confined Spaceis under gas purge or inert blanket Y/N Type of Gas: Entry Watch: Employer. For this specific confined space entry we have decided to use: Non-entry rescue procedures-(do not use if this would increase the risk of injury to the entrant orwould be ineffective). On-site rescue services which include:(list) 1)On-Site Rescue Personnel/Designation 3) 2) 4) 3) 5) □Off-site entry rescue services. The Entry Supervisor will contact_(name of rescue service) at (phone number) to doboth of the following ·Coordinate entry ·Schedule an entry date and time Methods of Communication:
Safety Watch to Rescue Personnet:□ Phone Audible Signal □ Radio (channel to monitor) Other Safety Watch to Entrants:□Radio (channe/to monitor) Audible Signal Visual Hand Signal Rope Signal Other
Safety Watch to Person in Charge of area:Phone Audible Signal Radio Other
Methods of Rescue: □External (Retrieval)Internal Congested
Hauling System RequiredPatient lowering system required/lowering area
Breathing Equipment and Gas Tester Requirements(check ☑where applicable below and indicatequantity needed):□ SCBA Airline Respirators: □Compressor (Grade D Air) Air Purifying Respirators(specity number and type required) Gas Testers:(specity number and type required): Stand-by Attendant (required to mentor compressor intake) Rescue Equipment Requirements(check ☑where applicable below and indicate quantity needed):Hauling Systems: Carabineers: Pulleys:Shock absorbers/lanyards: Anchor Straps: Webbing Ascenders: Body Hamesses: Rigging Plates: Safety Lines: Main Lines: Wrist/Ankle Hamesses: Fire Extinguishers: Stretcher. Ladder(type) □ Rescue Equipment Inspections Identified rescue equipment inspected by competent person: Record of inspection(s) attached Yes Medical Equipment Requirements(check where applicable below and indicate quantity needed):Trauma Kit Packaging Device: 口 Additional PPE Requirements (Indicate what is needed): □High Visibility Vests □Hearing Protection Safety Boots Hard Hats Safety Glasses/GogglesGloves Face Shield 口 口 CamScanner
