Template

Confined Space Evaluation Survey

by Jack Deyne, from the Community

10+

Use this confined space evaluation survey to determine if a space meets OSHA 1910.146 criteria and whether it is permit-required. Document atmospheric, engulfment, configuration, and other hazards; specify PPE, monitoring, ventilation, isolation, and rescue procedures; and capture photos and notes for compliance.

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Confirm accountability and compliance with a digital log

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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
Confined Space Assessment
This confined space assessment checklist helps teams classify spaces, identify hazards, and verify permit-required entry controls. Review atmospheric, engulfment, and configuration hazards; specify monitoring, ventilation, PPE, retrieval, and communication needs; confirm rescue arrangements; and document SDS review, isolation, testing, and hot work permits. Capture comments and signatures to ensure compliance and safer confined space operations.
by Ralpat98 User, from the Community
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Template
Confined Space Assessment Form
This Confined Space Assessment Form helps determine whether a space qualifies as permit-required by evaluating size, access, occupancy, and potential hazards. It guides users through atmospheric, engulfment, configuration, and other risks, and captures required PPE, monitoring, ventilation, isolation, and communication needs. It also documents rescue team readiness, retrieval systems, MSDS reviews, hot work permits, and special requirements for non-permit spaces, with space for photos, comments, and signatures.
by David Johnson, from the Community
Downloads: 10+
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Template
Confined Space Hazard Assessment
This Confined Space Hazard Assessment template helps teams determine if a space is permit-required by evaluating atmospheric conditions, engulfment risks, and configuration hazards. It guides users to specify required PPE and equipment, ventilation, communication, and retrieval systems, and to plan rescue/entry procedures. The checklist covers GFCIs, lighting, ladders, reduced visibility, noise, and other hazards, and records determinations, testing requirements, and sign-offs by safety, bioenvironmental, fire, and unit representatives.
by Christopher Rogers, from the Community
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Template
Confined Space Evaluation Form
This confined space evaluation form helps teams determine if a space is permit-required and safe to enter. Record location and description, assess access and occupancy, identify hazards such as hazardous atmospheres, engulfment risks, inwardly converging walls, mechanical and energized equipment, chemical and gas lines, temperature extremes, and hot work. Verify permits, isolation and lockout/tagout, ventilation, atmospheric testing, PPE, communication, attendants, and rescue plans before entry. Capture notes, photos, and sign-offs to document compliance and improve safety.
by Jeffrey Viehmann, from the Community
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Confined Space Assessment

This confined space assessment checklist helps teams classify spaces, identify hazards, and verify permit-required entry controls. Review atmospheric, engulfment, and configuration hazards; specify monitoring, ventilation, PPE, retrieval, and communication needs; confirm rescue arrangements; and document SDS review, isolation, testing, and hot work permits. Capture comments and signatures to ensure compliance and safer confined space operations.

by Ralpat98 User, from the Community

Get

Template

Confined Space Assessment Form

This Confined Space Assessment Form helps determine whether a space qualifies as permit-required by evaluating size, access, occupancy, and potential hazards. It guides users through atmospheric, engulfment, configuration, and other risks, and captures required PPE, monitoring, ventilation, isolation, and communication needs. It also documents rescue team readiness, retrieval systems, MSDS reviews, hot work permits, and special requirements for non-permit spaces, with space for photos, comments, and signatures.

by David Johnson, from the Community

10+

Get

Template

Confined Space Hazard Assessment

This Confined Space Hazard Assessment template helps teams determine if a space is permit-required by evaluating atmospheric conditions, engulfment risks, and configuration hazards. It guides users to specify required PPE and equipment, ventilation, communication, and retrieval systems, and to plan rescue/entry procedures. The checklist covers GFCIs, lighting, ladders, reduced visibility, noise, and other hazards, and records determinations, testing requirements, and sign-offs by safety, bioenvironmental, fire, and unit representatives.

by Christopher Rogers, from the Community

Get

Template

Confined Space Evaluation Form

This confined space evaluation form helps teams determine if a space is permit-required and safe to enter. Record location and description, assess access and occupancy, identify hazards such as hazardous atmospheres, engulfment risks, inwardly converging walls, mechanical and energized equipment, chemical and gas lines, temperature extremes, and hot work. Verify permits, isolation and lockout/tagout, ventilation, atmospheric testing, PPE, communication, attendants, and rescue plans before entry. Capture notes, photos, and sign-offs to document compliance and improve safety.

by Jeffrey Viehmann, from the Community

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Confined Space Evaluation Survey

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