Buderim Ginger Confined Space Entry

• Confined Space Entry Permit

• Conducted on

  Date

• Prepared by

• Location
  Address

• 1. Are all personnel currently trained in confined space entry?

  Yes

  No

  N/A

• 2. Workers are aware of potential hazards?

  Yes

  No

  N/A

• 3. Hazards have been addressed by using risk controls e.g. PPE, Elimination etc.

  Yes

  No

  N/A

• 4. Is appropriate signage displayed to alert personnel regarding CSE? i.e. No Entry Signs etc.

  Yes

  No

  N/A

• 5. If necessary, all energy sources have been isolated

  Yes

  No

  N/A

• 6. Entry and egress points are clear of obstructions?

  Yes

  No

  N/A

• 7. The work area is well lit?

  Yes

  No

  N/A

• 8. There is sufficient ventilation?

  Yes

  No

  N/A

• 9. Atmospheric Testing (if necessary) has been conducted?

  Yes

  No

  N/A

• 10. Atmospheric monitors have been challenge tested and are within calibration dates?

  Yes

  No

  N/A

• 11. If respiratory protection is needed, personnel have been trained in it's use?

  Yes

  No

  N/A

• 12. If gas cylinders are to be used, they have flashback arrestors fitted?

  Yes

  No

  N/A

• 13. Is communication available between the work team inside and the supervisor outside?

  Yes

  No

  N/A

• 14. Workers take regular breaks if a lengthy period of time is needed inside the confined space?

  Yes

  No

  N/A

• 15. All equipment is safe to use e.g. slings are inspected regularly?

  Yes

  No

  N/A

Recommendation & Evaluation

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