Title Page

  • Project

  • Sewer Structure
  • Conducted on

  • Prepared by

  • Document No.

  • No smoking, welding or fires within 6.0m of entrance to confined space<br>

  • Safety line used when access chamber is more than 2.0m deep<br>

  • Self rescue breathing sets available<br>

  • Electronic gas detection meter used prior to entry<br>

  • Peak gas levels at a safe level<br>

  • Three qualified personnel in working party<br>

  • Equal number of personnel at the surface as down below<br>

  • Communication maintained at all times between surface and below<br>

  • All personnel hold current confined space entry record of training<br>

  • Harness is being worn in access chambers greater than 2.0m deep<br>

  • Confined space entry form completed and sighted<br>

  • Radio or telephone communication available on site<br>

  • Communication with Water Agency at entry and exit to confined space<br>

  • Safety equipment is in good order, compliant to standards<br>

  • Three qualified personnel in working party<br>

  • Equal number of personnel at the surface as down below<br>

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