Title Page
-
Site conducted
-
Date and Time
-
Task
-
Work Location
-
Conducted on
-
Prepared by
Atmospheric Monitoring
-
1. Has the gas testing monitor been "Bump" tested prior to use?
-
2. Are the results from the gas test in the defined safe range?
-
3. Does the team know what alarms or conditions would trigger an evacuation?
-
4. Are there adequate controls (e.g. ventilation, gas monitoring frequency) for current and introduced hazards that could change the atmosphere? E.g. hot works, exhaust gases, chemical etc.
Entry Permit Execution
-
5. Has the confined space permit been issued? i.e. all persons have read and signed onto permit.
-
6. Is the team authorized and competent for the confined space task? i.e. for entry and standby.
-
7. Can the rescue plan be executed in a timely manner? i.e. team understands their role, communication devices working, rescue equipment available.
-
8. Are all access points to the confined space controlled by a standby person or barricading at all times?
Isolation and Verification of Zero Energy
-
9. Is an approved isolation procedure being followed?
-
10. Are all personal locks on the correct isolation point?
-
11. Have all energy sources been identified, isolated and checked for zero energy? E.g. process flows, mechanical, stored, hydraulic, pneumatic, chemical, electrical.
