Scribd
Upload
205 views1 page

Confined Space Entry Checklist

This document is a checklist for confined space entry that contains 23 requirements to check for safety. It includes checking that the space is barricaded, all energy sources are isolated, permits are completed, the atmosphere is tested, ventilation and PPE are provided, rescue procedures are in place, and communications equipment is available.

Uploaded by

DLPS HSE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
205 views1 page

Confined Space Entry Checklist

This document is a checklist for confined space entry that contains 23 requirements to check for safety. It includes checking that the space is barricaded, all energy sources are isolated, permits are completed, the atmosphere is tested, ventilation and PPE are provided, rescue procedures are in place, and communications equipment is available.

Uploaded by

DLPS HSE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

CONFINED SPACED ENTRY

CHECKLIST
DLPS-HSE-022/00

Project Name: ___________________________________________________________________________


Location: _______________________ Entry Date: _____________________________
Vessel/Equipment/Confined Space ID: _______________________________________________________

# Requirement YES NO N/A Remarks


1. Confined Space Entry Procedures/Instructions provided and available
2. Area barricaded and has warning signs posted
3. Electrical Sources Isolate
4. Process piping/ equipment isolated
5. Hydraulic/pneumatic and other energy sources isolated
6. Lockout and hold tag procedures followed
7. Hot/cold work permit completed
8. Confined Space entry permit completed
9. Atmosphere tested for % oxygen (O2)
10. Atmosphere tested % LEL
11. Atmosphere tested for hydrogen sulfide (H2S)
12. Atmosphere tested for other gases (e.g., CO), identify
13. Gases/chemicals purged flushed, vented
14. Continuous gas testing performed
15. Mechanical ventilation provided
16. Appropriate personal protective equipment (PPE) provided & used
17. Appropriate respirator(s) (e.g., SCBAs) provided and used
18. Full-body harness provide and used by each entrant
19. Appropriate lighting equipment provided
20. Rescue Service notified of confined space entry operations
21. Rescue equipment (e.g., hoist) available
22. Fire extinguisher(s) available at designated entry points
23. Standby man continuously present during confined space entry
24. Standby man has necessary PPE
25. Communications equipment for standby man and entrants provided
26. Entry log sheet available at designated entry points used

Remarks: ………………………………………………………………………………..................................
…………………………………………………………………………………………………………………

Issuer Name, Signature, Badge# Receiver Name, Signature, Badge # CSE Supervisor

Note: This checklist shall be completed by Work Permit Issuer and Receiver during their joint site inspection prior to signing each work permit
and before allowing confined space entry. The completed checklist shall remain with the Confined Space Standby Man on site after the joint site
inspection is complete.

You might also like