Information
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Audit Title
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This form is for categorising a place that is substantially (though not always entirely) enclosed and there will be a reasonably foreseeable risk of serious injury from conditions in the space of hazardous substances.
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Location
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Confined Space Ser No
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Take Photograph to show area, confined space and signage.
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Facilities
- Dave Hill
- Ciaran Dorrity
- Martin Richards
- Richard Mobley
- John Warner
- Brad Gelston
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Assessor if not Facilities Mech Team
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Select date
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Is the area enclosed or partial enclosed AND have a Specific Risk that makes it a Confined Space.
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1. Score each parameter against conditions provided - if in doubt score high.
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2. Total your score and compare withcategory/score bands.
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DEPTH
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ACCESS/EGRESS
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VENTILATION
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CHANCE OF TOXIC OR FLAMMABLE ATMOSPHERE OR OXYGENDEFICIECY
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CONTENTS
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AIR TEMPERATURE REACHING 30 DEGREES
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Score Analysis
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Total score - first number on top of page
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Additional Notes and Actions
