Andy's an Jonny's list

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Confined space

• Add media

  Media

• Has the tank been vented for 24 hrs

  Yes

  No

  N/A

• Is there adequate ventilation, either forced or natural for the task

  Yes

  No

  N/A

• Add media

  Media

• Is the risk assessment suitable and sufficient for the task

  Yes

  No

  N/A

• Add media

  Media

• Has a tollbox talk / JSA been completed and signed off by all personnel on the task

  Yes

  No

  N/A

• Add media

  Media

• Has a permit to work been raised and signed off by the appropriate responsible person

  Yes

  No

  N/A

• Add media

  Media

• Are copies of the permit to work available in the correct locations

  Yes

  No

  N/A

• Add media

  Media

Training

• Are all personnel trained in confined space

  Yes

  No

  N/A

• Add media

  Media

• Do all personnel know how to raise the alarm and summon help

  Yes

  No

  N/A

• Are the personnel trained in confined space rescue

  Yes

  No

  N/A

• Add media

  Media

• Are personnel trained in the use of harness, lanyards or restraints

  Yes

  No

  N/A

• Add media

  Media

• Do all personnel understand how to use the tripod<br>

  Yes

  No

  N/A

• Add media

  Media

• Are personnel trained in the use of gas testers

  Yes

  No

  N/A

• Add media

  Media

Testing

• Has the confined space been gas tested

  Yes

  No

  N/A

• Add media

  Media

• Is the gas tester calibrated and in date

  Yes

  No

  N/A

• Add media

  Media

• Have personnel gas detectors been issued

  Yes

  No

  N/A

• Add media

  Media

• Has a personnel gas tester been lowered into the tank prior to entry for the required time

  Yes

  No

  N/A

• Add media

  Media

• Have the radio's been issued and operationally checked, including specified channel selected

  Yes

  No

  N/A

• Add media

  Media

Emergency requirements

• Escape set issued

  Yes

  No

  N/A

• Add media

  Media

• Escape set tested and available in an emergency

  Yes

  No

  N/A

• Add media

  Media

• Are all personnel wearing suitable harness, lanyards or restraints for the specific task

  Yes

  No

  N/A

• Add media

  Media

• Tripod set up on entry point

  Yes

  No

  N/A

• Add media

  Media

• Tank sentry present

  Yes

  No

  N/A

• Add media

  Media

• Please provide details of the last emergency response practice that has taken place

• Select date

  Date

Signage

• Is there a gas free tag in place

  Yes

  No

  N/A

• Add media

  Media

• Ample warning signs in place, to warn others of tank entry

  Yes

  No

  N/A

• Add media

  Media

Other hazards

• Is there suitable lighting for the task

  Yes

  No

  N/A

• Add media

  Media

• Are all personnel clipped on at all times

  Yes

  No

  N/A

• Add media

  Media

• Is there adequate barriers around the area to prevent other personnel falling or coming into contact with the structure

  Yes

  No

  N/A

• Add media

  Media

• Are there Mechanical Hazards? If Yes, list.

  Yes

  No

  N/A

• Are there Electrical Hazards? If Yes, list.

  Yes

  No

  N/A

• Are there Heat and/or Cold Safety Concerns? If Yes, Explain.

  Yes

  No

  N/A

• Is there a potential for Reduced Visibility? If Yes, Explain.

  Yes

  No

  N/A

• Is there a Noise Concern? If Yes, Explain.

  Yes

  No

  N/A

• OTHER Hazardous Concern NOT listed?

PPE

• Are all personnel warning the correct PPE for the task and as stated in the risk assessment and toolbox/ JSA

  Yes

  No

  N/A

• Add media

  Media