Title Page
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Conducted on
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Prepared by
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Position
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Contract
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Location
Atmosphere, Engulfment, Ventilation and Fire:
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1. Has the atmosphere been tested and is it within the defined safe range?
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2. Are ventilation systems implemented effectively to ensure adequate ventilation, e.g. Dilution or Local Exhaust Ventilation (LEV)?
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3. Have ignition sources been eliminated where a flammable atmosphere exists?
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4. Have controls associated with engulfment been implemented effectively?
Plant and Equipment Testing:
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5. Is the gas monitor calibrated and bump tested prior to use?
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6. Is correct confined space entry equipment available and tested to the relevant standard, e.g. harnesses and rescue equipment?
Permit and Procedures:
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7. Has a risk assessment been completed and controls implemented effectively?
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8. Has an entry permit been issued for each confined space entry and controls implemented effectively?
People and Training:
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9. Are all employees involved in the confined space work suitably trained and assessed as competent?
Isolation:
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10. Are all energy sources controlled and locked out?
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11. Are all entry points to the identified confined space signposted and barricaded off to prevent unauthorised entry?
Standby Communication:
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12. Can the standby person (attendant) maintain continuous communication with employees working in the confined space?
Interactions:
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13. Are controls associated with other work party interactions implemented effectively? (e.g. other workers, plant and equipment)
Emergency Response:
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14. Is there a documented rescue and emergency plan available on site and are all work parties aware of the agreed process?
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15. Is rescue equipment set up or available on site?
