WORKPLACE INSPECTION NO 7: CONFINED SPACE ENTRY

• Inspector:

• Supervisor

• Company:

• Location:
  Address

• Date:

  Date

INSPECTION

• Valid Confined Space Entry Permit in place and JobSTART completed and communicated to workers

  Yes

  No

  N/A

• Correct signage in place “Confined Space No Unauthorised Entry”

  Yes

  No

  N/A

• All personnel trained and competent to enter Confined Space and to complete task

  Yes

  No

  N/A

• Atmospheric testing conducted and recorded (as required by Permit)

  Yes

  No

  N/A

• Gas testing equipment inspected and calibrated

  Yes

  No

  N/A

• Physical barrier in place to prevent unauthorised entry

  Yes

  No

  N/A

• Communications in place, suitable and understood by employees

  Yes

  No

  N/A

• Safe access provided – external / Internal

  Yes

  No

  N/A

• Spotter and stand by person in place, trained, understands responsibilities

  Yes

  No

  N/A

• Low voltage lighting used inside Confined Space

  Yes

  No

  N/A

• PPE requirements identified and complied with

  Yes

  No

  N/A

• Ventilation systems in place and operational

  Yes

  No

  N/A

• No exhaust fumes able to enter the Confined Space

  Yes

  No

  N/A

• All service lines and systems are isolated including purging activities

  Yes

  No

  N/A

• System in place to maintain record of entry /exit to confined space e.g. using log or tag board

  Yes

  No

  N/A

• Emergency rescue equipment and emergency response plan in place

  Yes

  No

  N/A

Inspection Team

• Signature:

  Sign

• Signature:

  Sign

• Signature:

  Sign