Information
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Document No.
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Audit Title
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Title of Confined Space
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Assessment Conducted on
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Prepared by
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Location of Confined Space
General Details
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Space Name
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Space Location
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Has space been entered on confined space register?
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Names of assessment team
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Date of Evaluation
Nature Of The Space
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Describe the Space
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Primary Intent of the Space
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What is the space made of
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Describe the entry points
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Photograph of space
Is Entry Necessary? (It is vital to consider the need to actually enter the space at all)
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Most probable tasks performed in the confined space?
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How often will these tasks be undertaken?
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Can the task be done without entering the space
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Can the task be done using any other method?
Inherent Atmospheric Hazards (during normal operation) If at risk: - Inherent risk level from STAR booklet - Controls measures - Residual risk
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Radiation
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Oxygen deficient or surplus<br>
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Combustible gases
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Toxic gases
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Fluids
Potential Hazards (When shutdown what could enter the space) If at risk: - Inherent Risk level from STAR booklet - Control measures - Residual Risk
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Contaminants in sludge, dust, packing and residual liquids
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Contaminants in fittings, etc
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Radiation
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Oxygen deficient or surplus
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Oxidation, decomposition
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Combustible gases
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Residual water
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Exhaust fumes from combustion engines in area
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Fumes and sparks from introduced power source, compressed air, welding, grinding or solvents<br><br><br>
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Fire / Explosion
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Unauthorised entry
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Engulfment
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Movement of the space
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Moving equipment (in/outside)
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Stored energy, or other energy sources
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Temperature extremes
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Natural hazards, insects, etc
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Electrocution
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Ergonomics, poor posture, etc
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Difficult access / egress
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Hazardous substances or chemicals
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Excessive noise
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Poor lighting
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Dust
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Remote location
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Poor communication
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Slips, trips or falls
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Other Risks
Specific Controls (Common basic controls listed below. Note: Other controls may be required to complete tasks inside the space. Refer to a risk assessment of the task)
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All confined space work will be carried out under the direction of BMSS-04
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Isolations required (List minimum isolations)
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Will the confined space require mechanical ventilation to promote air flow? <br>List ventilation locations
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Correct competency validation of personnel prior to starting work
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Is a standby person required?
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Persons to Contact Prior to Entry
- Production Manager
- Supervisor
- ERT
- Safety Department
- Radiation Department
- Control Room
- Other
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List Other Considerations
CONFINED SPACE EMERGENCY RESPONSE PLAN
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In all emergencys the standby person will follow the Heathgate MP-10 Emergency Management Plan.
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Equipment Required at Space
- Breathing Apparatus
- Blue Rescue Kit
- Stretcher
Emergency Response Team Requirements
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Notable Hazards
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Type of Rescue
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Emergency Rescue Plan<br>EMR-008 Confined Space Rescue Plan will be used along with
Extra Equipment Requirements for Rescue
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Tripod / Scaffold Frame
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Harness (attach at all times)
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Aussie Scoop Stretcher
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Polycarbonate Slide Sheet
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First Aid Trauma Kit
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First Aid Airway Kit
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Breathing Apparatus
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Lighting
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Hazardous Chemical Suit
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Fire Equipment
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Other Requirements
Rescue Rehearsal Requirements
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The rehearsal of these rescue procedures will take place by ERT during their regular training sessions.
Completion
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In the event of any emergency the alarm MUST be raised immediately. Standby personnel must be prepared to initiate rescue procedures. DO NOT enter the space in an emergency unless trained and if safe to do so. A qualified first-aider must be available in the event of an emergency. If trained and able to do so, attempt to extinguish a fire. If any situation is beyond control evacuate the area and wait further instructions.
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Assessor
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Responsible Person
