Confined Space Entry Permit Template
Confined Space Entry & Rescue Permit (AS 2865)
Heavy Industry & Energy Sector edition
$250AUDBuy now — editable Word
For entry into enclosed spaces — risers, pits, tanks, ducts, voids — with the atmospheric testing and entry controls required by AS 2865. High Hazard edition — editable Word document with its permit form built in. Choose your state at checkout.
The Heavy Industry & Energy Sector pack is the full permit-to-work system: this permit, the framework and every other permit in the tier. 11 editable Word documents for $2,419 AUD.
See the Heavy Industry & Energy Sector pack — $2,419What this permit controls
Controls entry into enclosed or partially enclosed spaces not designed for continuous occupancy — tanks, pits, vessels, ducts, risers, voids. Enforces atmospheric testing, ventilation, standby/rescue and entry authorisation in line with AS 2865.
Typical work covered
- ✓Tank, silo, vessel or pit entry
- ✓Sewer, manhole and pit inspection
- ✓Boiler, furnace and reactor entry
- ✓Ductwork, plenum and crawl-space access
- ✓Excavations and trenches deeper than 1.5 m with limited egress
- ✓Ship holds, storage tanks (oil, water, chemical)
Hazards this permit addresses
Each hazard is identified on the permit form with the controls that must be in place before the issuer signs.
Outcome if uncontrolled: Asphyxiation; fire / explosion risk increase.
Outcome if uncontrolled: Explosion on ignition.
Outcome if uncontrolled: Acute toxicity, unconsciousness, death.
Outcome if uncontrolled: Suffocation, crush.
Outcome if uncontrolled: Energy release during entry / work.
Outcome if uncontrolled: Failed rescue; rescuer becomes second casualty.
What the permit form includes
Editable Microsoft Word form. Yellow cells are the only ones you complete on a typical job. Sections:
How to use this permit
Identify and isolate energy sources (mechanical, electrical, fluid). Lock out and tag out. Ventilate if practicable.
Test in this order: O₂, LEL, toxics. Document the readings. Re-test on the interval specified in the permit; continuous monitor when feasible.
Standby person at entry point — does NOT enter. Rescue plan briefed and equipment staged.
Issuer signs the permit; entrants briefed; entry register populated. Each entrant signs in / out.
Confirm all entrants out, equipment removed, isolation restored if required, space secured. Sign close-out.
Frequently asked
What format is it in?
Editable Microsoft Word (.docx) with its permit form built in. Bracketed [fields] mark where to add your business name, ABN, site details and authorising officers.
Which jurisdiction do I get?
You choose your state at checkout (NSW, VIC, QLD, WA, SA, TAS, ACT or NT). The document references the Act, regulator and code of practice in force there — Victoria on OHS, the rest on harmonised WHS.
Is it cheaper in the pack?
Yes — the High-Hazard Pack bundles 11 documents for $2,419. Buying singles is best when you need only one or two.
Do I still need review?
Yes. This is a starting-point template; customise it to your site and have a competent person review it, in consultation with workers, before issuing live permits.
The complete Heavy Industry & Energy Sector permit-to-work system
One pack holds all 11 documents below, so every permit is issued, controlled and closed out on the same set of forms.
- ✓Permit-to-Work System & Framework
- ✓General Work Permit
- ✓Hot Work & Fire Watch Permit (AS 1674.1)
- ✓Energised Electrical Work Permit (AS/NZS 4836)
- ✓Working at Heights & Fall Protection Permit (>2m)
- ✓Confined Space Entry & Rescue Permit (AS 2865) (this page)
- ✓Excavation & Ground Penetration Permit (>1.5m)
- ✓Crane Critical Heavy Lift Permit (>80% Capacity)
- ✓Complex Scaffolding & Suspended Stage Permit (AS/NZS 1576)
- ✓Demolition & Structural Dismantling Permit (AS 2601)
- ✓Radiography / Density Gauge Permit (ARPANSA RPS C-1)
11 editable Word documents for your state. One-off payment.
See the Heavy Industry & Energy Sector packOr buy this permit on its own for $250.
Other heavy industry & energy sector permits
A Permit-to-Work Management System supplied as editable Microsoft Word documents, built to comply with the harmonised model WHS laws and Victoria's OHS Act 2004. Compliance is achieved by implementing and maintaining the system and having it reviewed by a competent person, in consultation with workers, for your site, plant and personnel; final responsibility under the legislation remains with the PCBU. Licensed for use within the purchasing organisation only. To the maximum extent permitted by law, the vendor's liability is limited to the price paid.