Confined Spaces – Task Analysis & Entry Permit
Company Name: / Person undertaking Risk Assessment:Date: / Contact Number:
A confined space is defined as an enclosed or partially enclosed space that is not intended primarily for human occupancy. It is liable to have an atmosphere that contains harmful or flammable contaminants or not contain a safe oxygen level. It may have contents that could cause engulfment.
This document addresses the requirements of AS 2865-2009 Confined Spaces and is designed to help you set up safely for confined space work, identify the hazards associated with the work, assess the risks and control these to ensure the job is completed safely.
When working in a confined space you should always Eliminate (E) any hazards. Where this is not possible, you must Minimise (M) the hazards. There may be occasions where multiple controls are appropriate.
Use this checklist to decide the best option/s available to control the hazard/s for the work you are about to undertake. Also use to brief everyone involved in completing the work and ensure the appropriate controls are in place. Once the above steps have been completed sign the form and keep onsite as part of your work documentation.
Note: All staff involved in Confined Space Entry must be trained to an appropriate standard (eg 17599 Plan a Confined Space Entry,18426 Confined Spaces & 25510 Atmospheric Testing) and be competent in confined space entry and work.
Please contact HazardCo on 0800 555 339 if you require any assistance to identify hazards or implement the required controls.
Pre Start Checklist – to be completed prior to commencing work
At Base / Yes / At Site / Yes1. HazardCo Team Pack or H & S docs in vehicle. / ❑ / 1. Park in a safe place. / ❑
2. Vehicle has a current WOF/COF, lights and tyres in working condition. / ❑ / 2. Ensure you wear your PPE/PPC and it is in good condition and appropriate for the work to be undertaken i.e. overalls, boots, mask, gloves, eye, hearing and respiratory protection. / ❑
3. Minimum PPE/PPC available and in good condition. / ❑ / 3. Hazard Board set up in the vicinity of where work is being undertaken. / ❑
4. All emergency equipment and materials required for the work being undertaken loaded and load secure. / ❑ / 4. Ensure you are inducted onto site - liaise with any site manager/contractor/client present to establish exactly what they are doing on site and any hazards associated with their work. Conduct your own induction if alone on site. Ensure the Hazard Board is updated. / ❑
5. All work documents for job in vehicle. / ❑ / 5. Explain to site manager/contractor/client any hazards you are bringing to site or that may be present as a result of your work (use HazardCo Client Induction Cards where appropriate). / ❑
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Confined Space Work Method
Describe how you plan to carry out the confined space work, using the example shown in the left hand column as a guide. Write your own method in the Work Method column on the right.
Work Method Example / Our Work Method1. Assess if work can be done without entering the confined space.
2. If not, complete Task Analysis and brief all staff on hazards – sign off form. Identify trained workers for entry and standy-by, and equipment required. Use equipment that will not produce additional hazards (fumes, noise etc) in the confined space if possible. / Complete Task Analysis and brief all staff on hazards – sign off form
3. Develop emergency rescue plan and check all equipment’s condition
4. Isoate the work area so only authorised people have access. Erect signage warning others of the hazards.
5. Open the confined space and leave to clear for a suitable timeframe. Ensure utility services have been identified and controlled.
Evaluate the confined space environment. Calibrate any detector equipment before putting it in the confined space work to ensure accurate reading of confined space environment.
6. Determine and implement ventilation and PPE requirements.
7. Implement monitoring controls for confined space during work.
8. Ensure stand-by person and rescue equipment are ready and means of communication is operational.
9. Prepare a Confined Space Entry permit
10. Identify safe access and egress.
11. Carry out work in confined space – identify any new hazards and be prepared to evacuate if required. Ensure monitoring takes place.
12. On completion of work tidy the work area, exit the space, secure the entry point to the space and pack up the site.
Preliminary Considerations Before Starting Confined Space Work
Have You? / Yes / No / Consider These Controls1. Located all underground services you may come in contact with? / ❑ / ❑ / · Dial before you dig (i.e. talk to the service owner regarding its isolation).
· Obtain diagrams and plans of underground utilities.
· Locate and mark all underground utilities.
· Isolate all utilities that may be affected by confined space entry, i.e. gas, electricity, water supply, sewerage etc.
2. Reviewed the work site and planned for the job? / ❑ / ❑ / · Identify the nature of the structure or confined space and determine best method of entry.
· Identify the best plant for the job based on access, right of way, headroom, overhead cables, bearing and capacity of ground and noise restrictions.
· Identify the best method of keeping water out of the confind space.
3. Provided protection to the public? / ❑ / ❑ / · All work areas must be fenced and or covered to prevent access to confined spaces by children or by the public.
· Provide warning signage and notices on all entrances to the work site.
· All work carried out on public property must have the approval of the local authority.
· Employ traffic control measure where required.
· Provide public protection where applicable.
4. Provided protection to your workers? / ❑ / ❑ / · Adequate overhead protection must be provided.
· Hard hats must be worn both in and out of the confined space where there is a risk of head injury.
· Suitable eye protection must be worn where there is a risk of eye injury i.e. windblown dust and debris.
· Hearing protection must be provided where employees are exposed to noise above 85 decibels.
· If working in and around hazardous substances provide overalls, gloves and facemasks and employ good hygiene practices to prevent potential for the spread of disease.
· All staff appropriately trained
5. Controlled any surface water (If applicable)? / ❑ / ❑ / · Control surface water away from confined spaces.
· Chanel ground water away from entry points and discharge clear of the working area.
· Use subsurface drains, well pointing or sump pumping to cut off, remove or intercept groundwater.
6. Provided safe access to the site? / ❑ / ❑ / · Provide safe access and egress of vehicles to site and clear areas for stores and equipment.
· Provide appropriate access and egress means for getting in and out of the confined space.
Have You? / Yes / N/A / Consider These Controls
7. Isolated any contamineants, services or moving parts? / ❑ / ❑ / · Always, as a first step, check to see if the work can be done with equipment from outside the confined space. The golden rule is: Don’t go in if you don’t have to. (E)
· Isolate services such as gas supplies and electricity. (E, M)
· Prevent accidental introduction of materials, e.g. steam, water etc. through piping, ducts or vents. De-energise, lockout or tagout machinery. (E, M)
· Be aware of gases that may be present in confined space such as methane, hydrogen sulphide, carbon dioxide, hydrogen sulphide, natural gas, steam, carbon monoxide, sulphur dioxide, petrol fumes, LPG and kerosene.(M)
· Where possible, atmospheric testing should be carried out without entering the confined space.(M)
· Test for toxic contaminants (e.g. hydrogen sulphide, methane, carbon monoxide) and combustible contaminants (e.g. petroleum vapours).(M)
· Use appropriate detection equipment, which should be correctly calibrated at regular intervals. (M)
· Ventilate the confined space by using a fan, by blowing air in with a compressor, or by opening more manhole covers or other entry or exit points. (WARNING: Never use oxygen to purge a confined space as it can create a fire and explosion hazard).(E, M)
· If the space can’t be ventilated, or if the work will contaminate the atmosphere (e.g. hot work, painting, sludge removal) then a suitable self-contained breathing apparatus or supplied-air respirator should be used. (M)
· Personal protective equipment (PPE) should only be used either as a last resort, or when all other control measures fail to control the risk, or in an emergency response. (M)
· The PCBU responsible for the work should issue a written authority – or confined space entry permit – as described in the Standard. Essentially, this permit is a safety checklist to make sure nothing is overlooked. The permit is attached to this document. (M)
· A stand-by person’s role is to monitor the safety of the person working inside the confined space and to take action if an emergency arises. Ensure there is a reliable system of communication – by voice, radio, hand signals, hard-wired communication, etc. This person must be trained. (M)
· Regularly test the air in a confined space constantly as oxygen and gas levels in a confined space can change quickly. Be alert for any change in conditions. (M)
· Ensure all staff are trained to an appropriate standard (eg 17599 Plan a Confined Space Entry,18426 Confined Spaces & 25510 Atmospheric Testing) and competent in confined space entry and work. Training records should be documented in a training register or similar. (E, M)
· Ensure you have an emergency plan to evacuate the confined space. Where necessary, there should be a system for getting a worker out of the space quickly if anything goes wrong. This could include using a safety harness and lifeline attached to a tripod. The Emergency Plan should be discssed as part of the induction and at pre start site meetings. (M)
8. Cleaned and purged the confined space where necesary? / ❑ / ❑
9. Tested the atmospere for oxygen deficiency? / ❑ / ❑
10. Tested the atmospere for toxic and combustible gasses? / ❑ / ❑
11. Ventilated the confined space? / ❑ / ❑
12. Selected the appropriate Breathing Apparatus? / ❑ / ❑
13. Selected the appropriate Personal Protective Equipment? / ❑ / ❑
14. Ensured all staff are trained in confined space entry / work? / ❑ / ❑
15. Ensured a trained standby person is outside the work area? / ❑ / ❑
16. Issued a written authority to enter the work area? / ❑ / ❑
17. Put an emergency / rescue plan in place? / ❑ / ❑
18. Ensured that you are regularly monitoring and maintaining your control measures? / ❑ / ❑
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Entry Permit
CSEP #: / Monitor Type:Supervisor: / Callibration Date:
Contact Cell Ph: / Permit Issue Date:
Site Address / location: / Permit Expiry Date:
List the Hazards and the Controls for this work
Tick the hazards you have identified in your assesment. / List the measures you will be using to eliminate (E), isolate (I) or Minimise (M) the permit space prior to entry. Ensure you list and describe each type of control. / E, I or MHAZARD IDENTIFIED / YES / NO / N/A / Example: Hazard Identified - lack of oxygen - Control = Do not enter confined space / E
1. Lack of oxygen / ❑ / ❑ / ❑
2. Oxygen enrichment / ❑ / ❑ / ❑
3. Combustible gases/vapours / ❑ / ❑ / ❑
4. Chemical contact / ❑ / ❑ / ❑
5. Electrical hazards / ❑ / ❑ / ❑
6. Mechanical hazards / ❑ / ❑ / ❑
7. Temperature / ❑ / ❑ / ❑
8. Engulfment / ❑ / ❑ / ❑
9. Entrapment / ❑ / ❑ / ❑
10. Other / ❑ / ❑ / ❑
Atmosphere Testing Table
test / Permissible entry
levels / Readings: Test 1
(top) / Test 2
(midpoint) / Test 3
(bottom) / Test 4
O2 / 19.5% to 23.5%
LEL / 0
H2S / 0
Co / 25ppm
Name of initial tester:
Test date & time:
Where continuous testing is required, times and results must be recorded on a gas monitor check sheet. Testing and recording requirements for this permit is a minimum of four times daily.
Entry Checklist
Complete the following checklist to confirm everything is in place prior to entry:YES / N/A / YES / N/A / YES / N/A
1. Confined Space TA completed, job procedures understood? / ❑ / ❑ / 2. Staff briefed and signed off TA as understood? / ❑ / ❑ / 3. All staff trained in confined space entry and any specialist equipment? / ❑ / ❑
4. SDS are available and have been reviewed for any Hazardous Substances? / ❑ / ❑ / 5. Welding, cutting or open flames are present and permit is to be used? / ❑ / ❑ / 6. Confined Space requires Isolation? / ❑ / ❑
7. Lock Out & Tag procedures are required and have been completed? / ❑ / ❑ / 8. Power sources are OFF and locked? / ❑ / ❑ / 9. Electrical hazards Isolated / removed and tagged? / ❑ / ❑
10. Lines carrying materials to and from confined space have been blanked off, removed or locked by two valves and drained ? / ❑ / ❑ / 11. Contents in Confined Space have been removed and the space flushed? / ❑ / ❑ / 12. Confined space atmosphere has been tested, prepared and monitored? / ❑ / ❑
13. Have you purged the confined space? / ❑ / ❑ / 14. Flanges / access doors and manholes have been opened? / ❑ / ❑ / 15. Continuous ventilation is provided? / ❑ / ❑
16. Oxygen levels are being maintained at over 19.5% but less than 23.5%? / ❑ / ❑ / 17. Continuous air monitoring equipment has been provided and is operational? / ❑ / ❑ / 18. PPE has been provided and specific instructions given in its use? / ❑ / ❑
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