MV BLUEFIN QUALITY MANUAL - Australian Maritime College

Australian Maritime College
Part D: Authorised person/Confined space work supervisor acceptance
I/We have checked the permits, procedures and isolations required for the safe entry and execution of the
work in the confined space.
Persons entering the confined space are listed below, and will log in/out and will comply with these, any
other reasonable instruction and in accordance with Australian Standard AS 2865.
The work area shall be checked and secured on completion of activities.
Name: ________________________________________
Name Date Time in Time out
Signature: _____________________________________ Date: ________________________
Part E: Log in/out
Part F: Close out (Authorised contractor)
Name:
Manager
Permit returned, work completed
Name:
Signature:
Date:
Signature Date:
Time:
File the completed form in the Contractors, Suppliers, Demonstrators and Visitors folder after the
“Confined Space Work Permits” tab.
Retain this form on site for 2 years then archive for a further 5 years.
Append 6.2 - Confined Space Work Permit.docx 3 of 3
Revised: November 2010