Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Has a risk assessment been carried out?
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Is the task being Supervised?
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Have all employees working in and around the confined space been adequately trained?
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Is there a record of air tests carried out before staff work in confined spaces?
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Is a permit to work system in place for all persons working in confined spaces ?
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Is all equipment used in confined spaces intrinsically safe and holding a current test certificate?
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Has safe access and egress been provided for the confined space?
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Are employees equipped with PPE?
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Is there a rescue plan and equipment in place?
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Are all relevant parties notified of the task at hand e.g Clinic , Fire and Emergency Rescue department?
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If one of the questions above was answered as No, immediately stop work and report to Supervisor or Superitendant.
