Confined Spaces Risk Assessment Form

Part 1 – General description of work

Location of work      

General description      

Who will be carrying out the work

Dimensions of the confined space

Part 2 – Hazards

Question Answer Is there a risk to those who
will work in the area?
What is/was stored in the            
confined space?
Are there any chemical residues?            
Are there materials or substances            
likely to enter from adjacent
What are the dimensions of the            
confined space?
Are harmful or explosive            
substances likely to be present?
Are flammable or toxic gases or            
vapours likely to be present?
Can power supplies be isolated?            

Is there a danger of explosion?            

Will sources of ignition be            
Can work take without the need            
for PPE/RPE?
Will any combustible materials be            
Will there be extreme            
temperatures or humidity?
Part 3 – Emergency arrangements

Are there arrangements for safe            
access and exit?
Is suitable rescue equipment            
Can the alarm be raised in the            
event of an emergency?
Are fire extinguishers provided            
where there is a risk of fire?
Can nearby plant and equipment            
be isolated?
Are there suitable first aid            

Quantum Risk Management Ltd t/a Quantum Compliance
23 Hanover Square, London W1S 1JB
34 Greenbox, Westonhall Road, Stoke Prior B60 4AL (Reg Office)
T 0800 644 4142 | W

Quantum Risk Management Ltd t/a Quantum Compliance 23 Hanover Square. Stoke Prior B60 4AL (Reg Office) T 0800 644 4142 | W qcompliance. Supervision       Competence of operatives       Means of communication       Testing/monitoring the       atmosphere Gas purging       Ventilation       Removal of residues       Isolation from gases. please do not hesitate to contact us via our website.Part 4 – Method statement This method statement takes account of the risks identified during the risk . etc.       Mechanical/electrical isolation       Work equipment       PPE (including RPE)       Access and egress       Fire prevention       Lighting       Static electricity       Emergencies and rescue       Work time restrictions       Prohibitions – the following  Smoking activities are not permitted  The use of internal combustion engines  The use of portable gas cylinders  Welding Other relevant information       Signature of Assessor       Date of Assessment Should you require any further assistance. London W1S 1JB 34 Greenbox. Westonhall Road.