Tasman Power Confined Spaces CCC

• Site conducted

• Date & Time

  Date

• Task

• Work Area

• Prepared By

Atmospheric Monitoring

• Has the gas testing monitor been 'bump' tested prior to use?<br>

  Yes

  No

  N/A

• Are the gas test results within the defined safe range?

  Yes

  No

  N/A

• Do you know what alarms or conditions would trigger an evacuation?

  Yes

  No

  N/A

• Are there adequate controls (e.g. ventilation, gas monitoring frequency) for current and introduced hazards that could change the atmosphere? e.g. hot work, exhaust gases, chemicals etc.<br>

  Yes

  No

  N/A

Entry Permit Execution

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are all access points to the confined space controlled by a standby person or barricading at all times?<br>

  Yes

  No

  N/A

Isolation and Verification of Zero Energy

• Have you followed an approved isolation procedure?<br>

  Yes

  No

  N/A

• Have you placed your personal lock onto the correct isolation point?<br>

  Yes

  No

  N/A

Isolation and Verification of Zero Energy

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

  Yes

  No

  N/A