Confined space entry permit builder

Draft a confined space entry permit: the space, the people, isolation, controls, atmosphere readings, rescue arrangements and the sign-off that everyone is out. Readings are checked against the regulation limits as you type.

Figures checked 5 November 2026. Free to use, no sign-in.

The space and the work

Victoria and Western Australia have their own Acts; the tool switches to them.

One space per permit.

People

A competent person.

Hazards and controls

Atmosphere test

% vol

Leave blank if not tested yet.

% LEL

Emergency and rescue

Confined space entry permit

Check before you use it

  • A permit covers one entry job. Issue a new permit if the space, the work, the people or the conditions change.
  • Train entrants, standby people and supervisors and keep training records for 2 years (s 76 of the Work Health and Safety Regulation 2025 (NSW)).
  • Consult the workers who will be affected, and their health and safety representatives if you have them (s 47 of the Work Health and Safety Act 2011 (NSW)).
  • Replace every [bracketed] item and delete defaults that don’t fit your workplace.
  • Check the current law and guidance from SafeWork NSW before relying on the document.
Permit number[Permit number]
Business (PCBU)[Business name]
Site[Site address]
Confined space[Identify the one confined space this permit covers]
Work to be done[Describe the work]
Permit valid from[Date and time]
Permit valid to[Date and time]
JurisdictionNew South Wales

Laid out against s 67 of the Work Health and Safety Regulation 2025 (NSW): a written permit, completed by a competent person, that names the space, the people permitted to enter, the period of the work and the risk controls, with space to confirm the work is finished and everyone is out. This is a draft prepared from the details entered. It does not by itself show that your obligations are met: check it against your workplace, consult the people who will use it, and update it when things change.

1. People

Permitted to enter (names):

  • [Name of each person permitted to enter]

Standby person, in continuous communication from outside and monitoring conditions (s 69 of the Work Health and Safety Regulation 2025 (NSW)): [Name]

Permit issued by (competent person): [Name and position]

2. Hazards

Hazards from the written risk assessment by a competent person (s 66 of the Work Health and Safety Regulation 2025 (NSW)). Risk assessment reference: [Reference or date]

  • Low oxygen
  • Toxic gas (for example hydrogen sulphide or carbon monoxide)
  • Flammable atmosphere
  • Engulfment or entrapment
  • Heat

3. Isolation of connected plant and services

Required by s 70 of the Work Health and Safety Regulation 2025 (NSW):

  • Isolate, lock and tag all inlet lines and valves
  • Isolate and lock out agitators, pumps and conveyors
  • Test that isolation works before entry

4. Risk control measures for entry

  • Ventilate the space before and during entry (never with pure oxygen)
  • Continuous gas monitoring while people are inside
  • No ignition sources in or near the space
  • Barricade the entry and put up a confined space sign at each entry

Signs at each entry identify the space and say no one may enter without a permit (s 68 of the Work Health and Safety Regulation 2025 (NSW)). No ignition source is brought into the space if fire or explosion is possible (s 73 of the Work Health and Safety Regulation 2025 (NSW)).

5. Atmosphere test before entry

Oxygen (safe level 19.5% to 23.5%)[Not tested]
Flammable gas (must be below 5% of LEL)[Not tested]
Continuous flammable gas monitoring in the spaceNo
Other contaminants[Results and exposure standards]
Tested by[Name, instrument and time]

ENTRY NOT AUTHORISED: atmosphere not fully tested

  • Oxygen: not tested yet. Test before anyone enters.
  • Flammable gas or vapour: not tested yet. Test before anyone enters.
  • Other contaminants: no results recorded. Test for any contaminant that could be present in this space.

6. Emergency, first aid and rescue

First aid and rescue procedures, practised and started from outside the space, with entry and exit openings large enough and unobstructed (s 74 of the Work Health and Safety Regulation 2025 (NSW)):

  • Standby person calls 000 and starts the rescue from outside the space
  • Retrieval tripod, winch and harness set up at the entry
  • First aider and first aid kit on site
  • Rescue procedure practised before the work starts

7. Authorisation

Permit issued by (competent person)Name ____________ Signature ____________ Date/time ________
Each entrant: read and understood this permitName ____________ Signature ____________ Date/time ________

8. Work complete: everyone out

I confirm the work in the confined space is complete and all persons have left it (s 67(2)(d) of the Work Health and Safety Regulation 2025 (NSW)).

Competent personName ____________ Signature ____________ Date/time ________

Keep this permit until the work is completed and the risk assessment until at least 28 days after; keep both for at least 2 years after a notifiable incident connected with the work (s 77 of the Work Health and Safety Regulation 2025 (NSW)).

Draft prepared with a free tool. Tailor it before use. General information, not legal advice.

Highlighted text in [brackets] still needs your input. Nothing you type is saved or sent. General information, not legal advice.

How this works

The permit is laid out against Part 4.3 of the WHS Regulations (r 66 to r 77, the same numbers in Western Australia) or Part 3.4 of Victoria’s OHS Regulations 2017 (r 55 to r 69), and the citations in the document change with your jurisdiction.

Oxygen readings are compared with the safe level of 19.5% to 23.5% and flammable gas with the 5% and 10% of LEL limits. A missing reading means entry isn’t authorised. Results for other contaminants are recorded but not checked: compare each with its workplace exposure standard.

Not included: the written risk assessment itself, gas detector calibration records and the rescue plan in full.

Legal basis

Checked against these sources on 5 November 2026. Spotted a figure that looks wrong? Tell us.

Questions

When do I need a confined space entry permit?

Before you direct a worker to enter a confined space to do work. Under r 67 of the WHS Regulations (the same number in WA) the permit must be in writing, completed by a competent person, and name the space, the people allowed in, the period of the work and the risk controls. In Victoria r 63 of the OHS Regulations 2017 sets similar content, and a permit can only cover one confined space.

What atmosphere readings allow entry?

Oxygen must be at a safe level, which the regulations define as 19.5% to 23.5% by volume, unless entrants use air-supplied respiratory equipment. Flammable gas must be kept below 5% of its lower explosive limit. Between 5% and 10% a worker may stay only if a calibrated continuous-monitoring detector is used in the space, and at 10% or more everyone must leave. Other contaminants must be below their exposure standards.

Does the standby person have to stay at the entry?

Under the model and WA regulations (r 69) the system of work must include continuous communication with the worker from outside the space and monitoring by a standby person in the vicinity. In Victoria (r 65) there must be continuous communication from outside and emergency procedures that can be started from outside.

How long do I keep the permit?

Until the work is finished, and for at least 2 years if a notifiable incident happens in connection with the work. Under the model and WA regulations the written risk assessment is kept until at least 28 days after the work.

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