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Authorise entry after verifying isolation, ventilation, atmospheric testing and rescue controls
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Pre-Entry Checklist
Mark the applicable column: P = Pass | F = Fail | N/A = Not applicable. Do not authorise entry if any critical item fails.
| # | Check | P | F | N/A | Notes / Action |
|---|---|---|---|---|---|
| Documentation & Planning | |||||
| 1 | Risk assessment completed for the confined space entry | ||||
| 2 | SWMS reviewed and signed by all entrants | ||||
| Isolation & Lockout | |||||
| 3 | Space isolated: mechanical (pumps, agitators, valves) | ||||
| 4 | Space isolated: electrical | ||||
| 5 | Space isolated: hydraulic / pneumatic | ||||
| 6 | Lockout/tagout verified: all energy sources locked out | ||||
| 7 | Space cleaned / purged (if required) | ||||
| Ventilation & Atmosphere | |||||
| 8 | Ventilation in place: natural or forced (mechanical) | ||||
| 9 | Atmospheric testing completed: results within safe limits (see table overleaf) | ||||
| # | Check | P | F | N/A | Notes / Action |
|---|---|---|---|---|---|
| Rescue & Emergency | |||||
| 10 | Communication system established (radio, voice, visual) | ||||
| 11 | Rescue plan in place and communicated to all personnel | ||||
| 12 | Rescue equipment available: tripod, winch, harness, breathing apparatus | ||||
| 13 | Signage and barriers in place around entry point | ||||
| 14 | Emergency contacts displayed on-site | ||||
| 15 | All entrants briefed on entry, exit and rescue procedures | ||||
Atmospheric Monitoring Safe limits: O₂ 19.5–23.5% | LEL <5% | CO <30 ppm | H₂S <10 ppm
| Time | O₂ % | LEL % | CO ppm | H₂S ppm | Other | Tested by |
|---|---|---|---|---|---|---|