Title Page
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Conducted on
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Prepared by
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Location
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Unit:
- FCC/Coker
- SRU/Boilerhouse
- AWWT
- NLIU
- SLIU
- Aromatics
- OM&S
- Other
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Other:
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Unit Area:
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Date/Time:
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Company being audited:
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Auditor:
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Auditor:
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1. Was the Confined Space Permit properly completed?
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Describe Deficiencies:
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2. Does permit give specific purpose/scope and location of entry?
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Describe Deficiencies:
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3. Was the authorization completed properly? (Operator, Issuing Authority, Entry Supervisor last)
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Describe Deficiencies:
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4. Is gas testing acceptable for entry? and have all section been completed with results, times and initials?
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Describe Deficiencies:
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6. Is continuous monitoring is being performed during entry. (i.e. welding, burning, applying coating)
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Describe Deficiencies:
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7. Is the Attendant/ Entrant communication adequate for the space and situation?
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Describe Deficiencies:
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8. If radio communication is being used, has radio been tested and Attendant able to demonstrate the method to contact the RSS or make emergency notification?
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Describe Deficiencies:
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9. Does attendant know job hazards and when to evacuate job site?
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Describe Deficiencies:
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10. Are the entrants logged in and out with their name and time?
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Describe Deficiencies:
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11. Is entrance properly marked with a Confined Space sign when no one is present?
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Describe Deficiencies:
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12. Are the entry controls/ PPE adequate to control the potential hazards?
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Describe Deficiencies:
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13. Is the rescue/ emergency equipment acceptable for entry, is rescue plan understood by attendant and crafts?
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Describe Deficiencies:
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14. Is the confined space ventilated properly?
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Describe Deficiencies:
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15. If IDLH the proper MOC’s conducted and signatures acquired?
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Describe Deficiencies:
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16. Did the craft complete FHA or similar hazard assessment?
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Describe Deficiencies:
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17. Has each craft obtained a different Craft section of the CSE permit and their hazards being controlled adequately?
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Describe Deficiencies:
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19. Are all applicable LOTO locks applied to board/ box?
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Describe Deficiencies:
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20. Is the confined space properly isolated of all possible energy sources?
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Describe Deficiencies:
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Have blanks been installed and the blank list verified for Hot Work?
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Describe Deficiencies:
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Were any immediate Corrective Action Taken:
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Corrective actions taken
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Is additional follow up needed:
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Follow up needed:
