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Free confined space entry permit

Free confined space entry permit (PDF-ready). Atmospheric testing, gas results, standby person, rescue gear, ventilation and isolation. Download free.

Updated 3 May 2026

Confined Space Entry Permit

Authorise entry after verifying isolation, ventilation, atmospheric testing and rescue controls

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0 of 15 checks

Documentation & Planning

1Risk assessment completed for the confined space entry
2SWMS reviewed and signed by all entrants

Isolation & Lockout

3Space isolated: mechanical (pumps, agitators, valves)
4Space isolated: electrical
5Space isolated: hydraulic / pneumatic
6Lockout/tagout verified: all energy sources locked out
7Space cleaned / purged (if required)

Ventilation & Atmosphere

8Ventilation in place: natural or forced (mechanical)
9Atmospheric testing completed: results within safe limits (see table overleaf)

Rescue & Emergency

10Communication system established (radio, voice, visual)
11Rescue plan in place and communicated to all personnel
12Rescue equipment available: tripod, winch, harness, breathing apparatus
13Signage and barriers in place around entry point
14Emergency contacts displayed on-site
15All entrants briefed on entry, exit and rescue procedures

Entry Authorisation

Permit issuer: signature

Entry supervisor: signature

Date & time

Standby person: signature

Print name

Date & time

Close-out Sign-off

Signature

Print name & position

Date & time

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These templates are free general guides provided as-is. They do not constitute legal, safety or compliance advice. You are responsible for ensuring any form meets your specific workplace obligations, industry standards and applicable regulations.

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Jarrod Milford

Jarrod Milford

Co-Founder & Commercial Director

Updated 3 May 2026
Also see:Compliance and inspections →Best inspection software →MapTrack vs SafetyCulture →

Short answer

A confined space entry permit records the space, the work, the entrants and standby person, isolation, ventilation, gas test results, rescue arrangements and close-out. A competent person completes it before work starts and closes it out when the work is done and every entrant is out. Part 4.3 of the model WHS Regulations sets duties for entry permits, atmosphere controls and records, and regulation 74 requires practised emergency procedures.

Checked against Model WHS Regulations as at 5 December 2025 (cited within as the Work Health and Safety Regulations 2011) on by the MapTrack templates team. How we check templates

Key takeaways

  • The MapTrack confined space entry permit contains 15 checks across 4 sections. Sections covered: Documentation & Planning, Isolation & Lockout, Ventilation & Atmosphere, Rescue & Emergency.
  • Test oxygen, flammable gas, carbon monoxide and hydrogen sulphide from outside the space with a calibrated detector before anyone enters, and keep monitoring if the atmosphere could change.
  • The standby person stays outside at the entry point for the whole entry and should never enter the space to attempt a rescue.
  • Do not authorise entry if any critical item fails, such as isolation, ventilation, atmospheric testing, the rescue plan or communication.
  • Issue a permit for the work before anyone enters. One permit can cover several entries into the space, but re-validate it if the person in charge of the work changes, work is interrupted, or the work brings new hazards or needs new controls.
  • Close the permit only after a head count confirms every entrant is out, tools are removed and covers or barriers are back in place.

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Used by construction, mining and field service teams

Saunders InternationalMineral ResourcesSupagasHacer GroupMetro TunnelUltrabuilt

What is a confined space entry permit?

A confined space entry permit is a formal authorisation document used to confirm that all safety controls are in place before workers enter a confined space. Under Australian WHS Regulations, a confined space is an enclosed or partially enclosed area not designed or intended for continuous human occupancy, with limited or restricted entry and exit, and where there may be a hazardous atmosphere, risk of engulfment, or other danger to health and safety. The permit records the space details, reason for entry, personnel (entrants, standby person, entry supervisor), pre-entry checklist covering isolation, ventilation, atmospheric testing, rescue plan and communication, atmospheric monitoring results, and is formally closed out when all entrants have exited and the space is secured.

Confined space incidents are among the most dangerous workplace events in Australia because conditions can change rapidly and rescue is inherently difficult. A well-completed permit ensures that every critical safety control has been verified before any person enters the space, and that a clear rescue plan is in place if something goes wrong. Would-be rescuers who enter without proper preparation can become casualties themselves, reinforcing the need for a rigorous, documented permit process before every entry.

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Benefits of using this confined space entry permit

  • Systematic risk control: confirm every critical safety control is in place before anyone enters the space.
  • Regulatory compliance: meet WHS Regulation requirements for confined space entry permits and demonstrate due diligence.
  • Atmospheric safety: the permit prompts mandatory gas testing and recording of results before and during entry.
  • Rescue readiness: verify that a rescue plan, trained standby person and rescue equipment are in place before entry.
  • Accountability: the permit records who issued it, who entered, and who is standing by, creating clear lines of responsibility.
  • Audit trail: a completed and closed-out permit provides documented evidence for safety audits and incident investigations.

Benefits of digitising forms in MapTrack

When you move your permits from paper to MapTrack, you get:

  • Field users can easily scan a QR code to complete a form on mobile. Unlimited users.
  • Email the right people when a form is submitted, with an automation you set up.
  • File every completed form against the asset, location or person it covers.
  • Download any completed form as a PDF, with failed answers listed at the top.
  • Fill in forms offline; they upload when the device is back online.
  • Build conditional logic (show or hide questions based on answers).
  • Take pictures or attach photos. Not possible with a paper-based form.
  • Electronic signatures.
  • Edit forms later without reprinting.
  • Set who can view, fill in or edit forms with user roles.
  • Upload a paper form (PDF, Word, Excel or a photo) and MapTrack's AI builds a digital version for you to check.
  • Email safety managers when a hazard report is submitted, with an automation you set up.
  • Keep every hazard and incident report against the site it came from, with photos.
  • Turn a hazard report into a corrective-action work order with its own review step.

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Steve McAllister

Asset Coordinator, Saunders International

What to include in a confined space entry permit

This confined space entry permit covers 8 key areas:

  • Permit details: permit number, date, valid from/to, site or location.
  • Confined space details: space name/ID, type, reason for entry, estimated duration.
  • Personnel: entrant names, standby person, entry supervisor.
  • Pre-entry checklist (P/F/N/A): risk assessment completed, SWMS reviewed, space isolated (mechanical, electrical, hydraulic, pneumatic), lockout/tagout verified, space cleaned/purged, ventilation in place, atmospheric testing completed, communication system established, rescue plan in place, rescue equipment available (tripod, winch, harness, breathing apparatus), signage and barriers in place, emergency contacts displayed, all entrants briefed.
  • Atmospheric monitoring table: time, O₂%, LEL%, CO ppm, H₂S ppm, other, tested by.
  • Continuous monitoring: yes/no indicator.
  • Entry authorisation: permit issuer, entry supervisor, standby person signatures.
  • Permit close-out: all personnel exited, space secured, permit cancelled, signed off.

How to use this confined space entry permit

  1. Complete the permit details - permit number, date, validity period, site and confined space identification.: Assign a unique permit number for traceability. Record the exact start and finish times the permit is valid for. Identify the confined space by name, asset ID or location reference so there is no ambiguity about which space is being entered.
  2. List all personnel - entrants, standby person and entry supervisor.: Record the full name and role of every person involved. The standby person must remain at the entry point for the entire duration and must not enter the space. The entry supervisor is responsible for cancelling the permit if conditions change.
  3. Work through the pre-entry checklist. Confirm isolation, ventilation, atmospheric testing, rescue plan and communication. Mark Pass, Fail or N/A for each item. Do not authorise entry if any critical item fails.: Verify that all mechanical, electrical, hydraulic and pneumatic energy sources are isolated and locked out. Confirm ventilation is running and effective. Check that rescue equipment is staged at the entry point and the communication system has been tested between the entrant and standby person.
  4. Conduct atmospheric testing and record results in the monitoring table. Confirm all readings are within safe limits before entry.: Use a calibrated four-gas detector to test oxygen, LEL, CO and H2S from outside the space before anyone enters. Record each reading with the time, location within the space and the name of the tester. Continuous monitoring is required if the atmosphere may change during the work.
  5. The permit issuer, entry supervisor and standby person sign to authorise entry.: Each signature confirms that the signatory has personally verified the controls relevant to their role. The permit issuer confirms all pre-entry conditions are met. Do not allow entry until all required signatures are obtained.
  6. When the work is complete, close out the permit - confirm all personnel have exited, the space is secured, and sign off.: Conduct a head count to confirm every entrant has exited the space. Remove all tools and equipment. Replace covers, guards or barriers. Cancel the permit with signatures and time, then file the closed permit for audit records.

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How often should you complete this permit?

A confined space entry permit must be issued for the work before any worker enters a confined space. The permit is valid only for the duration, space and scope of work described. One permit can cover several entries into the same space, but it should be re-validated when the person in charge of the work changes, when there is a break in work continuity, when changes to the work introduce hazards the permit does not address, or when new control measures are needed. If entrants exit the space and conditions may have changed, for example if atmospheric readings deteriorate, repeat the atmospheric testing before re-entry. The permit should be closed out as soon as all entrants have exited and the space is secured. Never allow entry on an expired or closed permit.

Under WHS Regulations 2011 (Chapter 4, Part 4.3) and AS 2865, the PCBU must not direct a worker to enter a confined space to carry out work unless it has issued a confined space entry permit for the work (regulation 67). Safe Work Australia's Code of Practice for Confined Spaces also says re-testing and continuous monitoring of the air may be necessary if conditions may change, so keep the atmospheric monitoring records alongside each permit. Organisations operating across multiple sites should standardise their permit format and review cycle to ensure consistency and audit readiness.

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Frequently asked questions

A confined space entry permit is a formal document that authorises specific workers to enter a confined space after confirming that all safety controls - atmospheric testing, isolation, ventilation, rescue plan and communication - are in place. Under Australian WHS Regulations, a confined space is an enclosed or partially enclosed area that is not designed for continuous human occupancy, has limited entry and exit, and may have a hazardous atmosphere, engulfment risk or other danger. The permit records the space details, personnel (entrants, standby person, entry supervisor), pre-entry checklist, atmospheric monitoring results, and is formally closed out when all entrants have exited and the space is secured.

Before entering a confined space, atmospheric testing must confirm safe levels for oxygen (O₂, between 19.5% and 23.5%), flammable gases (LEL, below 5% of the lower explosive limit), and toxic gases such as carbon monoxide (CO) and hydrogen sulphide (H₂S) below their workplace exposure standards. Additional gases may need to be tested depending on the space and the work being performed (e.g. nitrogen dioxide, ammonia, chlorine). Testing must be conducted from outside the space before entry, using calibrated instruments operated by a competent person. Continuous atmospheric monitoring during the work is required where there is a risk of the atmosphere changing.

A confined space entry permit must be issued by a competent person who has the knowledge, training and experience to assess the risks of the confined space and verify that all controls are in place. Under Australian WHS Regulations, the PCBU (person conducting a business or undertaking) must ensure the permit system is established and maintained. Typically, the permit issuer is a site supervisor, safety officer or person specifically trained and authorised to issue confined space permits. The entry supervisor (who may be the same person) oversees the entry and ensures the permit conditions are maintained throughout the work.

Yes. Download and use this confined space entry permit for free. It downloads as a ready-to-print PDF. No MapTrack account is required. If you later want digital permits with QR code scanning, electronic sign-on, atmospheric test logging and automatic audit trails linked to each confined space asset, MapTrack can do that. Book a demo to see how it works.

If atmospheric readings deteriorate during the work, all entrants must evacuate the space immediately using the pre-established rescue plan. The standby person initiates the emergency procedure and notifies the entry supervisor. The existing permit is cancelled, and no re-entry is allowed until the cause of the change has been identified, the space has been re-ventilated, fresh atmospheric testing confirms safe conditions, and a new confined space entry permit has been issued and signed. Continuous atmospheric monitoring during entry helps detect changes before they reach dangerous levels.

Applicable regulatory standards

This template is a starting point. Check the current requirements that apply to your equipment, work and location. The template alone does not establish compliance.

  • Model Work Health and Safety Regulations

    Edition: Model WHS Regulations as at 5 December 2025 (cited within as the Work Health and Safety Regulations 2011)

    Confined space duties: entry permits, signage, atmosphere controls, communication, emergency and rescue procedures, and record keeping.

    • Chapter 4: Hazardous work: noise, manual tasks, confined spaces, falls, high risk work licences, demolition, electrical and diving work.
    • Part 4.3: Confined spaces: entry permits, signage, atmosphere controls, communication, emergency procedures and record keeping.
    • reg 74: Confined space emergency procedures, including rescue and first aid, must be in place and practised.
    • reg 67: A PCBU must not direct a worker into a confined space without a written entry permit, completed by a competent person, naming the space, entrants, period and controls.
    • reg 77: Keep the confined space risk assessment for 28 days after the work and the permit until the work ends, or 2 years after a notifiable incident.

    Safe Work Australia (drafted by the Parliamentary Counsel's Committee)

  • Model Code of Practice: Confined spaces

    Edition: November 2024 version

    Model Code with practical guidance on permits, testing, isolation and rescue. Check the version approved in your jurisdiction.

    Safe Work Australia

  • Confined spaces

    Edition: AS/NZS 2865:2009 (incl. Amd 1:2025)

    Confined space risk assessment, emergency response, documentation and training records.

    • 3.3: Risk assessment for a confined space.
    • 2.8: Confined space emergency response planning, response and procedures.
    • 2.9: Documentation, document control and record keeping for confined space work.
    • 2.6: Training and competency for confined space work, including records of training.

    Standards AustraliaSold by the publisher

  • Occupational Health and Safety Regulations 2017 (Vic)

    Edition: Occupational Health and Safety Regulations 2017 (Vic), version 018 (in force from 20 October 2026)

    Victoria's confined space rules, including entry permits, emergency procedures and records.

    • Part 3.4: Confined spaces: identification, risk control, entry permits, emergency procedures and records.

    Victorian Government (Victorian Legislation)

  • 29 CFR Part 1910, Occupational Safety and Health Standards

    Edition: Current eCFR text, up to date as of 2026-10-22 (read 2026-10-26)

    US general industry: the permit space programme, entry conditions and testing, attendants and rescue services.

    • 1910.146: Permit-required confined spaces in general industry: evaluation, written programme, permits, atmospheric testing, attendants and rescue.
    • 1910.146(d): Sets what the permit space programme must include, from acceptable entry conditions and testing to attendants, rescue and review.
    • 1910.146(k): Rescue and emergency services: evaluating and preparing designated rescuers, and retrieval systems for entrants.

    US Occupational Safety and Health Administration (text via eCFR)

Each source was read at its publisher and the page checked on 26 October 2026. The publisher's current text is the authority.

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<div style="max-width:480px;font-family:system-ui,-apple-system,'Segoe UI',Roboto,sans-serif;border:1px solid #E5E7EB;border-radius:12px;padding:20px;background:#ffffff;">
  <p style="font-size:12px;font-weight:700;letter-spacing:0.05em;text-transform:uppercase;color:#071D49;margin:0;">Free template</p>
  <p style="font-size:18px;font-weight:700;color:#071D49;margin:6px 0 0;">Confined space entry permit</p>
  <ul style="margin:12px 0 0;padding-left:18px;color:#374151;font-size:14px;line-height:1.6;">
    <li style="margin:4px 0;">Permit details: permit number, date, valid from/to, site or location.</li>
    <li style="margin:4px 0;">Confined space details: space name/ID, type, reason for entry, estimated duration.</li>
    <li style="margin:4px 0;">Personnel: entrant names, standby person, entry supervisor.</li>
    <li style="margin:4px 0;">Pre-entry checklist (P/F/N/A): risk assessment completed, SWMS reviewed, space isolated (mechanical, electrical, hydraulic, pneumatic), lockout/tagout verified, space cleaned/purged, ventilation in place, atmospheric testing completed, communication system established, rescue plan in place, rescue equipment available (tripod, winch, harness, breathing apparatus), signage and barriers in place, emergency contacts displayed, all entrants briefed.</li>
    <li style="margin:4px 0;">Atmospheric monitoring table: time, O₂%, LEL%, CO ppm, H₂S ppm, other, tested by.</li>
    <li style="margin:4px 0;">Continuous monitoring: yes/no indicator.</li>
  </ul>
  <p style="font-size:13px;color:#6B7280;margin:14px 0 0;padding-top:12px;border-top:1px solid #E5E7EB;">Free <a href="https://www.maptrack.com/templates/confined-space-entry-permit" style="color:#071D49;font-weight:600;text-decoration:none;">Confined space entry permit</a> by MapTrack</p>
</div>

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The MapTrack confined space entry permit contains 15 checks across 4 sections.

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MapTrack Confined space entry permit, https://www.maptrack.com/templates/confined-space-entry-permit
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MapTrack. (2026). Confined space entry permit [Checklist template]. Retrieved from https://www.maptrack.com/templates/confined-space-entry-permit

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