Transcription of Confined Space Identification and Risk Assessment
1 Confined Space Identification and Risk AssessmentDate:Location: Space Number:Responsible Officer:CSE Authorising Officer:Classification of Space :ConfinedNilDescription of the Space :Section 1 Confined Space CRITERIONNo:For the Space to be Confined all points, to , must be answered with a the Space intended to be, or likely to be entered by any persons for any reasons ( maintenance, production or inspection)? the Space have a limited or restricted means of entry and exit for personnel? the Space intended to be at normal atmosphere pressure while any person is in the Space ? the Space likely to contain or once contained:YesNoan atmosphere that has a harmful level of any contaminant - : fumes, vapour, gas, steam, mist or explosive gas? Oran atmosphere that does not have a safe oxygen level - : too low or too high? Orany stored substance that could cause engulfment - : sand, garnet, grit, blast, grain?
2 SECTION Space classification:A full risk Assessment is required - Complete Section Classification:A full risk Assessment is required - Complete Section 3 can be used for this purposeYesNoSECTION 3 RISK ASSESSMENTNo:HazardYesNo Give Details Action/Controls the Space likely to or intended to be entered? : inspection of parts, maintenance requirementsAuthorised by Manager, Safety and Health1 Version March there a risk of the atmospheric pressure within thespace changing to an unsafe level? to entering the Space , is there any risk of the atmosphere being unsafe? fuel vapours, lack of oxygen due to decomposing material orexplosive inside the Space , is there a risk of any harmfulcontaminant or process entering the Space or beingcreated from inside? : fumes, carbon monoxide or gas leak, pipes, ducts, there any of the processes occurring inside or adjacent to the Space likely to cause oxygen deficiency?
3 Any other substance be introduced into the spacewhilst being occupied? : water, oil or there be insufficient lighting? there any possible hazards associated with thelighting in the Space ? : an explosive any electrical hazards present? continual communication between the personnelinside the Space and standby difficult? Protective EquipmentDoes the design, purpose or layout of the spacerequire PPE irrespective of the work carried outinside the Space ? Assessment TEAMR esponsible Officer:Date:CSE Authorising Officer:Date:Signature:Signature:Authori sed by Manager, Safety and Health2 Version March 2009
