Title Page

  • Confined Space Entry LCP

  • Which Site

  • Location
  • Conducted on

  • Audited by ?

  • People present

  • Any comments ?

General

  • 1) Has management designated entry supervisors and are training records available for the employee(s) that management has designated? tRaining must include the requirements, procedures and hazards of confined space entry.

  • Describe concern:

  • Add photo if necessary :

  • 2) Has a site specific written CSE procedure been developed?

  • Describe concern:

  • Add photo if necessary :

  • 3) Is retrieval equipment that will work with all types of confined spaces at the site available?

  • Describe concern:

  • Add photo if necessary :

  • 4) Are confined space permits completed for all confined space entries?

  • Describe concern:

  • Add photo if necessary :

  • 5) Has the site completed an evaluation of all spaces and identified the spaces that meet the parameters of a confined psace?

  • Describe concern:

  • Add photo if necessary :

  • 6) Are all confined space locations identified by posting a danger sign (Example "Danger - Confined Space - Do Not Enter - Permit Required") or by another equally effective means?

  • Describe concern:

  • Add photo if necessary :

  • 7) Have all entrants been trained on the policy and the proper use of all confined space entry equipment?

  • Describe concern:

  • Add photo if necessary :

Entrants

  • 8) Do all entrants wear a chest or full body harness and a retrieval line for all vertical entries or a wristlet for horizontal entries?

  • Describe concern:

  • Add photo if necessary :

  • 9) Is a method of communication between the attendant and entrant established prior to entry such that the attendant is able to determine entrant status and alert entrants to evacuate the space if needed?

  • Describe concern:

  • Add photo if necessary :

  • 10) Do entrants know to exit the space when:<br>a. Ordered to exit by the attendant OR entry supervisor<br>b. A prohibited condition exists<br>c. Signs or symptoms of exposure to a dangerous situation are recognised<br>d. An evactuation alarm has activated

  • Describe concern:

  • Add photo if necessary :

Attendant

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

  • Describe concern:

  • Add photo if necessary :

Entry Supervisor

  • Describe concern:

  • Add photo if necessary :

Training

  • Describe concern:

  • Add photo if necessary :

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