Confined space permit to work template. Description. Our construction health and safety specialists have produced the template, ready for you to complete for your particular confined space activity. This document will give you a good indication of the hazards associated with the activity, along with the risks and controls you should be thinking about. Employers are required to control high risk activities. A permit to work is a formal recorded process used to control work which is identified as potentially hazardous. It is also a means of communication between site management, plant supervisors and operators and those who carry out the hazardous work. You may use the confined space permit to work as it is, in your business, and can add your company name at the top. However, the assessment is provided as a template and you need to check the permit is suitable for your work process, making any amendments as required to cover the activities carried out within your organisation. The document is provided in Office Word format and the document text fields are fully editable to suit your business activities and control measures. Once downloaded you are free to save, edit, print and use the confined space permit to work template within your business for as long as you need it. Contents: » Activity» Project» Person in Charge» Location» Description of Work» Precautions Before Work» Precautions During Work» Operative Precautions» Test Precautions» Hazardous Atmosphere» PPE / Equipment Precautions» Declaration» Permit Acceptance» Permit Continuation» Permit Cancellation/Completion. Confined Space Program is to set procedures that will ensure workers safe entry into confined spaces and permit. Sample Written Program Author: nuv5 Last. This confined space permit template provides you with a document to control confined space activities on your sites, giving you a checklist of controls and a record. Confined space entry permit. location (fac #): authorized entrant(s): authorized attendant(s): dept/div/shop: 1) 2) time: purpose of entry: description.
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September 2016
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