Template

Confined Space Permit to Work Sunflower Plant

by Brenden Giuffrida, from the Community

10+

This Confined Space Permit to Work template for sunflower processing plants guides teams through safe entry planning and authorization. It includes fields for work details, gas monitoring readings oxygen LEL CO H2S isolation requirements ventilation, PPE and training confirmations, emergency procedures, and conditions for entry. The permit defines validity one day only, requires standby personnel log in and log out, and captures issuer authorization and close out sign off for the HSE manager.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Advanta Seeds Confined Spaces Permit to Work
This Confined Spaces Permit to Work template helps teams control high-risk entries by documenting the proposed work and location, gas monitor readings (Oxygen 19.5–23.5%, Combustible <5% LEL, CO <30 ppm, H2S <10 ppm), required isolations, ventilation, PPE, and training. It records permit validity, issuer and entrant details, standby personnel, calibration bump test, and entry conditions (with supplied air or escape unit). The template includes authorization, log in/out tracking, and closeout to return the permit to the HSE Manager once work is completed. Ideal for agriculture facilities such as silos, tanks, and pits.
by Brenden Giuffrida, from the Community
Downloads: 20+
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Template
Advanta Seeds Confined Space Permit to Work
Use this Confined Space Permit to Work template for Advanta Seeds reprocessing plants to manage safe entry into silos, bins, pits, tanks, and other confined spaces. The checklist captures job details, location, gas monitoring results for oxygen, LEL, CO, and H2S, mechanical and electrical isolations, ventilation, PPE, danger tags and signage, training verification, and emergency procedures. It includes authorizations, shift validity, entry logs, and closeout sign-off to ensure compliance with site and HSE requirements. Adaptable to seed processing operations and similar plant environments.
by Brenden Giuffrida, from the Community
Downloads: 10+
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Template
PC HS 25 Confined Space Entry Permit
This PC HS 25 Confined Space Entry Permit template helps teams plan and authorize safe entry into confined spaces. Record project details, location, work scope, permit number, and date. Verify gas testing for oxygen, H2S, explosivity, CO, and other gases with equipment type and calibration dates. Confirm the safe system of work, removal of noxious substances, and full isolation from energy sources. Checklist items cover access control, communications, standby person, first aid, signage and barriers, PPE, intrinsically safe tools, adequate lighting and ventilation, tripod and retrieval gear, and escape breathing apparatus. Document continuous gas monitoring, pre-entry briefing, worker medical fitness and training, and emergency rescue arrangements. Supervisor authorizes before entry and cancels the permit once work is complete and the area is left safe. Permit validity is limited to one day.
by Kevin Baker, from the Community
Downloads: 0
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Template
Confined Space Permit
Use this confined space permit to plan and authorize entry into tanks, pits, vessels, and other confined spaces. The form captures permit identifiers, work scope, location, start and finish times, isolation and lockout verification, atmospheric testing requirements and results, ventilation, PPE, communication, standby and rescue arrangements, and continuous monitoring. It includes approvals, issue, acceptance, clearance, and closure sections, plus a gas test record for oxygen, flammable gases, CO, H2S, and dust or fibers. Suitable for construction, facilities, utilities, manufacturing, and mining operations.
by Stephen Dawson, from the Community
Downloads: 0
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Advanta Seeds Confined Spaces Permit to Work

This Confined Spaces Permit to Work template helps teams control high-risk entries by documenting the proposed work and location, gas monitor readings (Oxygen 19.5–23.5%, Combustible <5% LEL, CO <30 ppm, H2S <10 ppm), required isolations, ventilation, PPE, and training. It records permit validity, issuer and entrant details, standby personnel, calibration bump test, and entry conditions (with supplied air or escape unit). The template includes authorization, log in/out tracking, and closeout to return the permit to the HSE Manager once work is completed. Ideal for agriculture facilities such as silos, tanks, and pits.

by Brenden Giuffrida, from the Community

20+

Get

Template

Advanta Seeds Confined Space Permit to Work

Use this Confined Space Permit to Work template for Advanta Seeds reprocessing plants to manage safe entry into silos, bins, pits, tanks, and other confined spaces. The checklist captures job details, location, gas monitoring results for oxygen, LEL, CO, and H2S, mechanical and electrical isolations, ventilation, PPE, danger tags and signage, training verification, and emergency procedures. It includes authorizations, shift validity, entry logs, and closeout sign-off to ensure compliance with site and HSE requirements. Adaptable to seed processing operations and similar plant environments.

by Brenden Giuffrida, from the Community

10+

Get

Template

PC HS 25 Confined Space Entry Permit

This PC HS 25 Confined Space Entry Permit template helps teams plan and authorize safe entry into confined spaces. Record project details, location, work scope, permit number, and date. Verify gas testing for oxygen, H2S, explosivity, CO, and other gases with equipment type and calibration dates. Confirm the safe system of work, removal of noxious substances, and full isolation from energy sources. Checklist items cover access control, communications, standby person, first aid, signage and barriers, PPE, intrinsically safe tools, adequate lighting and ventilation, tripod and retrieval gear, and escape breathing apparatus. Document continuous gas monitoring, pre-entry briefing, worker medical fitness and training, and emergency rescue arrangements. Supervisor authorizes before entry and cancels the permit once work is complete and the area is left safe. Permit validity is limited to one day.

by Kevin Baker, from the Community

Get

Template