Tasman Power Confined Space Entry CCFV

• Site conducted

• Date and Time

  Date

• Task

• Work Location

• Conducted on

• Prepared by

Atmospheric Monitoring

• 1. Has the gas testing monitor been "Bump" tested prior to use?

  Yes

  No

  N/A

• 2. Are the results from the gas test in the defined safe range?

  Yes

  No

  N/A

• 3. Does the team know what alarms or conditions would trigger an evacuation?

  Yes

  No

  N/A

• 4. Are there adequate controls (e.g. ventilation, gas monitoring frequency) for current and introduced hazards that could change the atmosphere? E.g. hot works, exhaust gases, chemical etc.

  Yes

  No

  N/A

Entry Permit Execution

• 5. Has the confined space permit been issued? i.e. all persons have read and signed onto permit.

  Yes

  No

  N/A

• 6. Is the team authorized and competent for the confined space task? i.e. for entry and standby.

  Yes

  No

  N/A

• 7. Can the rescue plan be executed in a timely manner? i.e. team understands their role, communication devices working, rescue equipment available.

  Yes

  No

  N/A

• 8. Are all access points to the confined space controlled by a standby person or barricading at all times?

  Yes

  No

  N/A

Isolation and Verification of Zero Energy

• 9. Is an approved isolation procedure being followed?

  Yes

  No

  N/A

• 10. Are all personal locks on the correct isolation point?

  Yes

  No

  N/A

• 11. Have all energy sources been identified, isolated and checked for zero energy? E.g. process flows, mechanical, stored, hydraulic, pneumatic, chemical, electrical.

  Yes

  No

  N/A