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Confined Space Entry Checklist Ref:

Contractor: Inspected by:

Equipment Model: Job Title:
Site Location: Inspection Date:

S. N Description YE No N/A Remarks

S
1. Are confined spaces completely emptied of any hazardous
substances & materials, such as acids, asbestos prior entry?
2. Are all energizer/power supply lines to a confined space, having,
highly toxic, flammable, or corrosive materials and or materials cut
off, isolated, disconnected before entry?
3. Are all rotating component, parts, and equipment (impellers)
inside confined spaces locked-out if they present a serious hazard
to operators/technicians?
4. Is either natural or mechanical ventilation & exhaust system is
provided and or installed before confined space entry?
5. Are essential atmospheric tests conducted to know oxygen
deficiency, toxic substances, chemicals and explosive
concentrations in the confined space prior entry?
6. Is enough required illumination provided for the work activity/task
to be performed in the confined space?
7. Is the atmosphere inside the confined space regularly tested &
monitored during the work?
8. Is there a responsible appointed HSE standby personal outside of
the confined space when needed, whose core responsibility is to
continuously watch and monitor the work in progress, sound an
alarm if required, and provide assistance?
9. Is the standby employee competent and experienced and well
trained and equipped to handle any emergency?
10. Are the standby personal or other employees restricted from
entering the confined space without proper and essential
recommended PPE’s such as lifelines and respiratory equipment if
there is any emergency exist?
11. Is approved (from national and international governing bodies, or
Government intuitions) respiratory equipment needed if the
atmosphere inside the confined space cannot be made acceptable
for work?
12. Is all Portable Electrical Equipment (PEE), machinery, devices used
inside confined spaces either grounded and insulated, or equipped
with Ground-fault Circuit Interrupters (GFCI)?
13. Prior any hot work activity is started in a confined space, are hoses
inspected, checked and tested for any leaks, compressed gas
bottles forbidden inside of the confined space, lights always keep
outside of the confined area and the confined area tested for an
 explosive atmosphere each time before a lighted torch is to be
taken into the confined space?
14. If workforce using Oxygen Consuming Equipment (OCE) eg, lights
or another heating system in a confined space, is sufficient air
provided to assure combustion without reducing the oxygen
concentration of the atmosphere below 19.5 per cent by volume
as per required standards?
15. While combustion-type equipment is used in a confined space,
always make sure the exhaust gases are vented outside of the
confined space?
16. Is each confined space inspected, and appropriately observed for
decaying vegetation or animal waste which may produce
methane?
17. Is the confined space examined for possible industrial waste which
could contain highly toxic and flammable properties?
18. If the confined space is underground and near areas where
gasoline fuel consumer vehicles will be operating, is it possible for
vehicle exhaust or carbon monoxide to enter the space?
19. Is confined space Entrants technicians/workers wearing proper
PPE’s (for example hardhats, boots, etc.)?
20. Do you know the location of the nearest operation
centre/emergency phone numbers?

Name Job Title Signatures Date

Inspected by:

Reviewed by: