Consultancy of Hydro Confined Space Rescue - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Add location
  Address

• Select date

  Date

Site Arrival

• Has a site induction been completed and are you aware of the hazards on site?

  Yes

  No

  N/A

• Has a risk assessment been completed on the area of operation?

  Yes

  No

  N/A

• Has the work authority been granted?

  Yes

  No

  N/A

• Has the permit been signed and issued?

  Yes

  No

  N/A

• Is all of the required equipment available and serviced/calibrated including but not limited to: <br>Fall arrest PPE<br>Gas detector<br>Tripod <br>Rescue equipment <br>BA<br>

  Yes

  No

  N/A

Set up pre entry of confined space

• Has the area been cordoned off?

  Yes

  No

  N/A

• Are 'lock out tag outs' required?

  Yes

  No

  N/A

• Has the atmosphere been tested and is it safe for entry?

  Safe

  At Risk

  N/A

• Is a safety observer in place

  Yes

  No

  N/A

• Means of communication from the observer to entrant established?

  Yes

  No

  N/A

• Has safe access been set up for entry including but not limited to: <br>Tripods <br>Scaffolding<br>Anchors<br>

  Yes

  No

  N/A

• Rescue and evacuation plan in place

  Yes

  No

  N/A

During entry

• Ensure safe practices are followed

  Safe

  At Risk

  N/A

• Continuous monitoring of confined space atmosphere

  Yes

  No

  N/A

Conduct simulated rescue

• Has equipment been set up correctly

  Yes

  No

  N/A

• Are back ups in place for simulation

  Yes

  No

  N/A

• Has an appropriate anchor been selected

  Yes

  No

  N/A

After exit

• Account for all personnel and equipment

  Yes

  No

  N/A

• Secure the entry point to the confined space

  Yes

  No

  N/A

• Sign off permit

  Yes

  No

  N/A

• Review of operation

  Yes

  No

  N/A

Mighty River Power Requirements

• Provide photo of full confined space set up

  Media

• What is the advised methodology for entry?

  Yes

  No

  N/A

• Has the equipment been identified and what is the appropriate equipment required for task?

  Yes

  No

  N/A

• Has the appropriate anchor been selected and what is the most appropriate system?

  Tripod

  Anchor installation

  Temporary scaffold anchor

• What is the recommended manning power for the task?

  1

  2

  3

  4

  5

• Has a successful rescue been conducted and what is the methodology?

  Yes

  No

  N/A

• Provide photo of full rescue set up

  Media