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Keep workers secure with a confined space entry form

Keep workers secure with a confined space entry form

This confined space entry checklist for access to confined spaces is based on the EU-OSHA standard operating procedure.

Use this template
or download pdf
Keep workers secure with a confined space entry form

This confined space entry checklist for access to confined spaces is based on the EU-OSHA standard operating procedure.

Use this template
or download pdf

About the Keep workers secure with a confined space entry form

The confined Space Entry Checklist is a safety checklist used when entering a confined space. It outlines safety measures and protocols to follow, such as ensuring proper ventilation, monitoring the atmosphere, and wearing proper safety gear. It also includes pre-planning steps and checklists for assessing and monitoring the work environment.

A Confined Space Entry Checklist is a tool used to ensure the safety of personnel who are entering a confined space. It includes a series of steps to be taken before, during, and after entry. These steps include assessing the risk of hazards, assessing the need for specialized equipment, and providing proper training. The checklist also covers emergency protocols, such as calling for assistance and evacuation, as well as post-entry evaluations. By taking the time to complete the checklist carefully, personnel can ensure a safe and successful entry into the confined space.

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Preview of the template
Audit
Pre-operation
Make sure to isolate the space from all hazards.
Remove all unauthorized personnel from the site of entry.
Perform the LOTO procedure.
Make sure to check for any blocking inlets, etc.
Ventilate the space (if necessary).
Fill out the Entry Permit.
Evaluate the confined space.
Test the atmosphere
Fill out the atmosphere readings on the permit.
Make sure to place the completed permit on or nearby the PRCS.
Work In-Progress
Enter the confined space and proceed with work.
Check if the responsible supervisor is available.
Check if the attendant is at the entry site.
Check if the safety harness is utilized
Check if the required PPE is being worn.
Retest the atmosphere as needed or required.
Post operation
Remove all personnel, tools, as well as debris from the space.
Close the space.
Cancel the permit.
Review the procedure with the employer (for hazards, problems, etc.)
File the permit when completed and closed
Recommendations
Enter your recommendations here
Completion
Full Name and Signature of Inspector
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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.