Tarong Energy Corporation
Confined Space Entry Authorisation
Site
Tarong Power Station
PTW No:
Plant Covered:
OIC Name:
Document: Confined Space Entry Authorisation:
Form T-0399 (01/08)
This form is used in conjunction with the Procedure for Safe Working in a Confined Space (OHS-PROC-18)
Page 1 of 6
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Space Location:
KKS Number:
Date of Evaluation:
Reg Number:
NATURE OF THE SPACE:
Describe the Space:
Primary intent of the space:
What is the space made of:
Describe the entry points:
PHOTO / PLAN OF THE SPACE:
IS ENTRY NECESSARY? (It is vital to consider the need to actually enter the space at all.)
Most probable task performed in the confined
space?
-
How often will these tasks be undertaken?
-
Can the task be done without entering the space?
-
Can the task be done using any other method?
-
Additional Notes:
Tarong Energy Corporation
Confined Space Entry Authorisation
Site
Tarong Power Station
PTW No:
Plant Covered:
OIC Name:
Document: Confined Space Entry Authorisation:
Form T-0399 (01/08)
This form is used in conjunction with the Procedure for Safe Working in a Confined Space (OHS-PROC-18)
Page 2 of 6
\\TTFP01\cbay$\Desktop\Website\Confined Space Authorisation form.doc
Part 1: Confined Space Inherent Risk Assessment:
ATMOSPHERIC HAZARDS:
Risk Level
Hazard
N/A
Low
Med
High
Controls/ Comments (Note: Controls must be
considered in accordance with the principals of the
hierarchy of control).
Oxygen deficient or surplus
Combustible gases
Toxic gases
Contaminants in sludge etc
Contaminants in fittings etc
Decomposition
Other causes
Additional atmospheric testing is required as follows:
Is continuous monitoring required?
YES
NO
Is additiona