# Form - Hazmat Entry Log and Air Monitoring Record

> Fire Service Safety Management System, version 0.3.3 (2026-10-25). The Human Factor. Document FSSMS-FRM-37.
>
> Canonical: https://thehumanfactor.ca/library/fire-service-safety/form-hazmat-entry-log-and-air-monitoring-record
>
> Licence: CC BY-NC-SA 4.0 with the Adopting Agency Grant (https://creativecommons.org/licenses/by-nc-sa/4.0/)
>
> General information only, not legal, medical or other professional advice. Verify every requirement against the current official text of the law, standards and manufacturer instructions that apply to you. Obtain your own legal review and consult your joint health and safety committee before adopting anything. You adopt, adapt, implement and rely on this material entirely at your own risk and on your own responsibility. Full terms: Terms of Use, thehumanfactor.ca.

## Purpose and use

One record for every incident where air is monitored or a member enters a warm or hot zone: hazmat releases, unknown substances, gas leaks, carbon monoxide calls, battery and energy storage incidents, and overhaul monitoring. Part A sets the scene; Part B proves the instruments were ready; Part C is the monitoring record; Part D is the entry and exit log with medical monitoring; Part E closes out. It is the record behind the member’s exposure report and, decades later, behind a presumptive illness claim ([NFPA 470, 2022](https://thehumanfactor.ca/library/fire-service-safety/form-hazmat-entry-log-and-air-monitoring-record#ref-nfpa-470); MLITSD, n.d., GN 6-51). It answers the accreditation criteria on hazmat regulatory compliance and exposure record keeping [(CPSE, 2019, criteria 5H.2 and 11A.10)](https://thehumanfactor.ca/library/fire-service-safety/form-hazmat-entry-log-and-air-monitoring-record#ref-cpse-2019).

Kept by the entry control officer at the warm-zone boundary and by the member running the instrument. Two copies on every first-due apparatus and in the hazmat unit.

## The form

### Part A: Incident and zones

| Field | Entry |
|:---|:---|
| Incident number; date; location type (occupancy, roadway, rail, marine, site) |  |
| Product or hazard (name, UN number, ERG guide number, or “unknown”); source of identification |  |
| Energy system involved (EV, battery device, ESS, PV, hydrogen, gas, electrical) |  |
| Zones set (hot, warm, cold) and time; wind direction and speed; weather |  |
| IC (role); hazmat officer or group supervisor (role); hazmat safety officer or ISO (role); entry control officer (role) |  |
| Regional or provincial team requested (time); utility requested (time); CANUTEC consulted (time) |  |

### Part B: Instrument readiness

| Instrument (type, ID) | Bump test (date, time, result, by) | Last calibration (date) | Sensors fitted (O2, LEL, CO, H2S, HCN, PID, radiation) | In service (Y/N) |
|:---|:---|:---|:---|:---|
|  |  |  |  |  |

### Part C: Air monitoring readings

| Time | Location (zone, side, floor, point) | O2 % | LEL % | CO ppm | H2S ppm | HCN ppm | PID ppm | Radiation (unit) | Action level reached (which) | Action taken | Initials |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
|  |  |  |  |  |  |  |  |  |  |  |  |
|  |  |  |  |  |  |  |  |  |  |  |  |
|  |  |  |  |  |  |  |  |  |  |  |  |

Monitoring points to include: pre-entry at the boundary; during entry; the decon corridor; rehab; overhaul; the perimeter watch at battery incidents (start and end of the watch period).

### Part D: Entry and exit log

| Team \# | Members (role, ID) | Competency level | PPE class or ensemble | SCBA cylinder (size) and pressure in | Pre-entry vitals (time; by) | Time in | Task | Expected out | Time out | Pressure out | Post-exit vitals (time; by) | Decon complete (time) | Exposure report filed (Y/N) |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |

Backup team (members, PPE, ready time): \_\_\_ Decon team (members, PPE level): \_\_\_ Corridor checklist completed (time; by): \_\_\_

### Part E: Close-out

Final readings time: \_\_\_ Zones released (time): \_\_\_ Hazard handed over to (who, when, what they were told): \_\_\_ Watch period start and end (battery incidents): \_\_\_ Equipment bagged for cleaning or disposal (list): \_\_\_ Runoff contained and disposal contact: \_\_\_ All warm and hot zone members listed on exposure reports (Y/N): \_\_\_ Near-miss reports filed (count): \_\_\_ Entry control officer signature (role, date): \_\_\_ HSO received (date): \_\_\_

## Fields

| Field | Type | Required | Who completes |
|:---|:---|:---|:---|
| Incident, product, energy system, zones, roles, requests | Text; lookup; time | Yes | Entry control officer |
| Instrument ID, bump, calibration, sensors, in service | Lookup; date-time; result; list; yes/no | Yes per instrument used | Instrument operator |
| Readings row | Time; text; numbers; choice; text; initials | Yes per reading | Instrument operator |
| Entry row | Lookup; choice; text; numbers; times; yes/no | Yes per team entry | Entry control officer; medical monitor for vitals |
| Backup and decon teams; corridor checklist | Lookup; time | Yes per entry incident | Entry control officer |
| Close-out fields | Times; text; yes/no; count; roles and dates | Yes | Entry control officer; HSO |

## Records

Filed with the incident record in {{Records system}}; the exposure data is copied to the exposure register by the HSO and kept for the member’s career plus 30 years, or longer where your jurisdiction’s retention rule for exposure records requires it ([J09 Records Retention](https://thehumanfactor.ca/library/fire-service-safety/j09-records-retention)). Vital signs are recorded as values only, with no interpretation; the medical record stays with the physician. Instrument logs feed the calibration record. Readings at action levels and any entry without a backup team go to the [Corrective Action Register](https://thehumanfactor.ca/library/fire-service-safety/corrective-action-register) and the triage record.

> **Note: Customize**
>
> Print the department’s action levels along the top of Part C. Drop the radiation and PID columns on the first-due apparatus copy where those instruments are not carried. Add the pre-entry vital sign thresholds set by the physician to the margin of Part D.

## Jurisdiction requirements

This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it.

| Topic | What to check in your jurisdiction | Page |
|:---|:---|:---|
| Records Retention | Any retention period the law sets for exposure, health surveillance and medical records (career plus 30 years is this program’s default) | [J09 Records Retention](https://thehumanfactor.ca/library/fire-service-safety/j09-records-retention) |

## References

Center for Public Safety Excellence \[CPSE\]. (2019). *Fire and emergency service self-assessment manual* (10th ed.). Commission on Fire Accreditation International. <https://cpse.org/wp-content/uploads/2019/08/10th-Edition-FESSAM-Strikethrough-Underline-v.4.pdf>

National Fire Protection Association. (2022). *NFPA 470, Hazardous materials/weapons of mass destruction (WMD) standard for responders* (consolidates NFPA 472, 473 and 1072). <https://www.nfpa.org/codes-and-standards/nfpa-470-standard-development/470>

Ontario Ministry of Labour, Immigration, Training and Skills Development \[MLITSD\]. (n.d.). *Firefighter guidance notes* (Section 21 Advisory Committee; individual notes revised to 2026). <https://www.ontario.ca/document/firefighter-guidance-notes>
