Run Manhole and Vault Entry Atmospheric Test Log — Free

Inspection Details

Entry location identified

Record the manhole or vault identifier, address, asset number, or other unique location reference.

Inspection date and time

Document when the atmospheric test log was completed.

Inspector / tester name critical (required)

Name of the qualified person performing the atmospheric test and entry verification.

Work order or permit number

Record the associated work order, permit, or job control number.

Pre-Entry Conditions

Space identified as permit-required confined space critical (required)

Confirm the manhole or vault has been evaluated and controlled as a permit-required confined space where applicable.

Yes No N/A

Entry authorization completed before entry critical (required)

Verify entry authorization, permit approval, and required pre-entry checks were completed before anyone entered.

Yes No N/A

Area secured from unauthorized access critical (required)

Confirm barriers, covers, cones, or other controls are in place to prevent unauthorized entry or exposure.

Yes No N/A

Isolation and energy control verified critical (required)

Confirm applicable lockout-tagout, blanking, disconnect, or other isolation measures are in place before entry.

Yes No N/A

Atmospheric Testing

Initial atmospheric test completed before entry critical (required)

Verify the atmosphere was tested before any entry into the manhole or vault.

Yes No N/A

Oxygen concentration critical (required)

Record the measured oxygen concentration at the opening and at representative levels in the space.

Combustible gas reading critical (required)

Record the combustible gas concentration as a percentage of the lower explosive limit (LEL).

Toxic gas readings recorded critical (required)

Select any toxic gases tested for and document the measured values in comments if applicable.

Note (optional)

Atmospheric test results acceptable for entry critical (required)

Confirm all required readings were within acceptable limits before entry was authorized.

Yes No N/A

Ventilation and Entry Controls

Mechanical ventilation in operation critical (required)

Confirm ventilation equipment is operating when required and air movement is directed to the space as intended.

Yes No N/A

Ventilation maintained during entry critical (required)

Verify ventilation remained in operation throughout entry when required by the permit or site procedure.

Yes No N/A

Continuous or periodic monitoring established critical (required)

Confirm the monitoring frequency or continuous monitor requirement was established and followed during entry.

Yes No N/A

Entry controls and attendant in place critical (required)

Confirm an attendant, communication method, and entry control measures were in place before and during entry.

Yes No N/A

Deficiencies, Corrective Actions, and Sign-Off

Deficiencies or non-conformances documented

Record any unsafe conditions, failed tests, ventilation issues, or entry control deficiencies observed.

Corrective actions completed before entry continued critical (required)

Confirm corrective actions were completed and the space was re-tested before entry continued after any deficiency.

Yes No N/A

Inspector signature critical (required)

Signature of the qualified person completing the log.

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Run: Manhole and Vault Entry Atmospheric Test Log

Inspection Details

Pre-Entry Conditions

Atmospheric Testing

Ventilation and Entry Controls

Deficiencies, Corrective Actions, and Sign-Off

Get your results