Confined Space Permit Checklist

Use this Confined Space Entry Permit Checklist to verify permit conditions, controls, monitoring, and rescue readiness before and during confined space entry.

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Health & Safety
Confined Space Permit Checklist

Administrative Authorization

Hazard Identification & Isolation

Atmospheric Monitoring

Safety Equipment & PPE

Rescue & Emergency Services

Permit Completion & Cancellation

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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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Confined Space Permit Checklist

Use this Confined Space Entry Permit Checklist to verify permit conditions, controls, monitoring, and rescue readiness before and during confined space entry.

1. Is the Confined Space Entry Permit clearly posted at the entry portal?

2. Has the Entry Supervisor signed the permit to authorize the commencement of work?

3. Are the date and duration of the permit clearly defined, and do they not exceed the work shift?

4. Is the purpose of the entry and the specific work to be performed documented?

5. Are the names of all Authorized Entrants and the Attendant listed on the permit?

1. Have all physical hazards (e.g., mechanical, electrical, thermal) been identified and recorded?

2. Have Lockout/Tagout (LOTO) procedures been completed and verified for all energy sources?

3. Have all lines and pipes been blanked, blinded, or disconnected to prevent the entry of hazardous materials?

4. Has the confined space been cleaned or purged of hazardous contaminants prior to atmospheric testing?

1. Has the atmosphere been tested for oxygen content, and is it within the acceptable range (19.5% to 23.5%)?

2. Have flammable or explosive gas levels been tested and confirmed to be less than 10% of the LEL?

3. Have toxic vapors, including Hydrogen Sulfide (H2S) and Carbon Monoxide (CO), been tested, and are they within safe limits?

4. Is the tester’s name, the time of testing, and the gas monitor serial number recorded on the permit?

5. Is the gas monitor currently calibrated, and has a bump test been performed today?

1. Has Personal Protective Equipment (PPE) appropriate to the hazards (e.g., gloves, eye protection, respiratory gear) been inspected and is it adequate?

2. Are communication tools between the Entrant and Attendant (e.g., radios or signals) available and verified to be working?

3. Is forced-air ventilation in use where required and positioned to avoid drawing in contaminated air?

4. Are non-sparking tools and explosion-proof lighting provided where a flammable atmosphere may be present?

1. Is a retrieval system (e.g., tripod, winch, and full-body harness) in place and ready for immediate use?

2. Have emergency rescue services been notified of the entry and has their availability been confirmed?

3. Are the means of summoning rescue (e.g., phone, radio, or alarm) clearly identified on the permit?

1. Is the permit cancelled or terminated upon completion of the work or if a prohibited condition arises?

2. Are all entrants and equipment accounted for before the confined space is closed?

3. Has the completed permit been returned to the safety department and retained according to requirements?