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Confined space/permit space evaluation survey - Ship Shape Consulting Mobile App

Some questions asked in this checklist include; Is the space large enough and so configured that an employee can enter and perform assigned work? Is the space not designed for continuous employee occupancy? Does the space contain or have a potential to contain a hazardous atmosphere? Examples: combustible dusts, flammable mixtures, or oxygen deficiency that may expose employees to the risk of death, incapacitation, or acute illness. Does the space contain another serious safety or health hazard? Examples: radiation, noise, electricity, and moving parts of machinery. If any answer is Yes, this is permit space. An entry permit is required for entry.

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

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Take a peek inside the Confined space/permit space evaluation survey - Ship Shape Consulting Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date of this survey

  • Ico multiline

    Name/description of this space

  • Ico multiline

    Location of this space

  • Ico textbox

    Person performing this survey

  • Ico statictext

    Use this section to determine if the space is a confined space

  • Ico checkbox

    Is the space large enough and so configured that an employee can enter and perform assigned work?

  • Ico checkbox

    Does the space have restricted means for entry or exit?

  • Ico checkbox

    Is the space not designed for continuous employee occupancy?

  • Ico statictext

    If all three answers are Yes, this is a confined space.

  • Ico statictext

    Use this section to determine if the space is a permit space

  • Ico checkbox

    Does the space contain or have a potential to contain a hazardous atmosphere?

  • Ico checkbox

    Does the space contain a material that has the potential for engulfing an entrant?

  • Ico checkbox

    Does the space have an internal configuration such as inwardly converging walls or a sloping floo...

  • Ico checkbox

    Does the space contain another serious safety or health hazard?

  • Ico statictext

    If any answer is Yes, this is permit space.

  • ...and More!

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