Time :___________________

 

Reason(s) for Entry:  ___________________________________________________________________ YES NO Remarks – Mandatory if “NO” 1 Are the Pumproom ventilation fans running and working correctly? 2 Have arrangements been made for continuous ventilation, including during work breaks? 3 Is the fixed gas test equipment on and working accurately? 4 Is the pump room rescue equipment available for immediate use? 5 Does the person entering the pumproom have a hand held radio? 6 Are ELSAs fully charged and operational 7 Is access to work area in the pumproom well lit, with any hazardous areas highlighted or roped off? 8 Have all personnel who are to enter the pumproom been briefed on the entry and evacuation procedure?   9 Has a responsible person been informed that the pumproom is being entered and have effective communications been established?  

ATMOSPHERE TEST – RECORD OF RESULTS

GAS

Maximum Permitted

Actual

    Hydrocarbon (HC)  < 1% LEL Hydrogen Sulphide (H₂S) 10 ppm Benzene (C₆H₆) 1 ppm Carbon monoxide (CO) 50 ppm Sulphur dioxide (SO₂) 5 ppm Other toxic gas Oxygen (O₂) 20.8%  

ENDORSEMENTS:  MAXIMUM time between gas readings = 4hrs

Time HC O₂ H₂S C₆H₆ CO SO₂ Other toxic gas Signature