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Ventia - Confined Space Risk Assessment & Permit
Ventia - Confined Space Risk Assessment & Permit
Kurtis Carlyle

Ventia - Confined Space Risk Assessment & Permit Checklist

July 2019 updated

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Confined space risk assessment

Is it a Confined Space?
To establish if a space is a potential Confined Space the following questions need to be answered. The first step is to examine the physical characteristics and the inherent hazards of the space itself, not the task or any tasks to be performed within that space.

Is the space an enclosed or partially enclosed space that is not intended or designed primarily as a place for human occupancy?

Is the space liable at any time to have?
a) An oxygen concentration outside the safe oxygen range
b) A concentration of airborne contaminant that may cause impairment, loss of consciousness or asphyxiation
c) A concentration of flammable airborne contaminant that may cause injury from fire or explosion
d) Engulfment in a stored free-flowing solid or rising liquid that may cause suffocation or drowning.

This works area is NOT deemed to be a confined space. Continue works as per your SHEWMS and/or work instructions. Notify a supervisor if you are unsure about the outcome of this assessment.

This works area IS deemed to be a confined space. Continue with the risk assessment below.

Atmospheric conditions

Test the atmosphere for 5 minutes around the entry and at different locations in the space (e.g. working area, top, middle, bottom) and record the readings below

Gas monitor serial number

Do you know the bump test procedure?

Which type of monitor are you using?

This gas monitor can not be bump tested on site, return to storeman for testing.

Honeywell Bump Test.JPG

Has the gas monitor been successfully bump tested this shift?

Stop and bump test before proceeding. If you are unable to bump test or the test was unsuccessful, notify your supervisor immediately.

Oxygen Oxygen Deficiency if < 19.5% Oxygen Enrichment if > 23.5%

Hydrogen Sulphide <10ppm

Carbon monoxide <30ppm

Lower Exposure Limit (LEL) % <10%

Are all readings within safe levels?

Continuous monitoring is to be carried out through the duration of the works in the workers breathing space.

Is entry necessary?

Can the task be done without entering the space?

Discuss with your supervisor.

Can the task be done using any other method?

Discuss with your supervisor.

Hazard assessment

Are there any unusual features and / or adjacent processes that may impact on the need, or safety, of entry.

Describe the feature/s or process/es and how you will control the risks.

Oxygen deficiency or surplus

List the controls

Combustible atmosphere

List the controls

Toxic atmosphere

List the controls

Fluids

List the controls

Contaminants

List the controls

Oxidisation, decomposition

List the controls

Moving equipment (in/outside)

List the controls

Engulfment

List the controls

Pressurised lines (air/fluid/gas)

List the controls

Machinery that may auto start

List the controls

Natural hazards, insects etc.

List the controls

Electrocution

List the controls

Ergonomics (poor posture)

List the controls

Difficult access/egress

List the controls

Fire/explosion

List the controls

Hazardous chemicals

List the controls

Excessive noise

List the controls

Poor lighting

List the controls

Dust

List the controls

Remote location

List the controls

Poor communication

List the controls

Competent person

Confined Space Permit

Did the Risk Assessment deem the work area as a confined space?

Complete the Confined Space Entry Permit below.

Confined Space Entry Permit

Work Controls

Confined space physically isolated from hazardous energy

Emergency response plan in place and understood

Confined space been cleaned and/or purged of contaminants

Appropriate type / suitable number of fire extinguishers

If hot works are undertaken, dedicated Fire Watch during and 30 minutes after works required and organised

Weather conditions considered e.g. risk of heavy rain/potential flooding

Adequate earthing to electrical equipment

All electrical equipment is intrinsically safe

Confined Space Entry Log

Breathing apparatus required and organised

Standby and entry personnel fit and competent

Gas testing / monitoring required and organised including Atmospheric Monitoring Log

Associated pipelines, tanks, valves certified gas /liquid/vapour free and isolated

Exclusion zone set up and adjacent works considered

Area barricaded and warning signage in place

Extraction / forced ventilation required and organised

Flammable/Combustible materials removed from area

First Aider with CPR competency required and organised

Communication equipment required, organised and tested

Safe & adequate access and egress

Additional PPE
PPE Required
  • Face Shield
  • Respiratory Protection
  • Face Shield
  • Hearing Protection
  • Chin Strap
Permit issue/acceptance

Before issuing this permit, a rescue plan must be completed on the next page.

Persons working under permit

A person required to work under this Permit to Work (PTW) must comply with \ the following instructions:
1. Ensure you understand the scope of the work activity and your role / tasks.
2. Ensure you have read, and/or have had explained and understand the requirements of the SHEWMS and any associated Permits. Ask questions if you are unsure and report any concerns / issues immediately.
3. At the start of each working shift ensure the Permit Acceptor has had the Permit revalidated and obtained permission to commence work.
Notify the Permit Acceptor immediately if you become aware of a new hazard or change in conditions while performing the works.

Sign on
Sign on
Entry / Exit record

I’VE BEEN ADVISED OF AND UNDERSTAND THE CONTROL MEASURES AND PRECAUTIONS TO BE OBSERVED WITH THE ENTRY AND WORK IN THE CONFINED SPACE

Sign in/out
Time in
Sign in
Time out
Sign out
Permit close out - Completion of works

All works associated with this permit have been:

All persons and equipment accounted for:

Equipment checked and restocked correctly:

Work area & adjacent areas have been inspected after completion of the works and all hazards made safe:

Works completed
Permit issuer: I confirm that the works have been completed and that the area has been left in a safe condition.

No permit required.

Rescue Plan

IMPORTANT NOTE
Emergency procedures are to be rehearsed prior to works commencing. Should a change occur to the crew a new plan, with roles identified shall be made.

Emergency Response Equipment required
  • Gas monitor
  • Tripod/Davit arm
  • Safety harness
  • Winch system
  • Lighting
  • Fall arrest
  • Fall restraint
  • Life line/Rescue rope
  • Stretcher
  • BA kit
  • Arachnipod

Site Location Details (including muster / meeting points):

Roles and Responsibilities
Who will conduct the confined space rescue / retrieval?
Who will notify and meet emergency services:
Who will conduct First Aid/CPR:
Rescue Plan Details

Types of rescue arrangements.

rescue types.JPG
Basic sketch of confined space work area and rescue arrangement.
Confirmation

Have all participants been briefed on and agree with the emergency rescue plan?

Do not commence works until all parties have been briefed and agree to the plan.

Ventia - Confined Space Risk Assessment & Permit
Kurtis Carlyle

Ventia - Confined Space Risk Assessment & Permit

July 2019 updated

Use this Digital Checklist
Download as PDF
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.

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