Fill this in, print it, and post it at the space. Nothing is sent to a server — the form keeps a draft in this browser only. The example below shows a completed permit; Clear empties it.

This form records what you enter. It ships no gas thresholds of its own — the acceptable entry conditions are the ones your own program specifies, typed in by you. Whether a reading is acceptable is the entry supervisor's judgement, not this page's.

The space and the permit

Permit number Space ID Space name Location Date Authorised from Authorised to Purpose of entry

Acceptable entry conditions

From your own written program. This form ships no defaults — a blank box means nothing is being compared against anything.

Oxygen — min % Oxygen — max % Flammable — max % LEL Carbon monoxide — max ppm Hydrogen sulphide — max ppm

Atmospheric test results

Tested before entry and re-tested through it. The times matter as much as the numbers — the standard asks for the results and when they were taken.

Instrument used — make, model, serial

Time	Stage	O₂ %	% LEL	CO ppm	H₂S ppm	Tested by

Authorised entrants

Who may go in, and who is in there now. Answering that second question at any moment is the reason the attendant role exists.

Name	Company or crew	Time in	Time out	Status

Attendant and entry supervisor

Attendant on duty Entry supervisor Rescue service to call

Entry supervisor — signature to issue

Entry supervisor — signature to cancel

Date and time cancelled

draft kept in this browser

This page will not remember this permit

Close the tab and it is gone. Fine for one entry — but 1910.146(e)(6) says the cancelled permit is kept at least a year and reviewed, and a year of permits in a drawer is how most sites fail that part.

Confined Space Entry Permit