Confined Space Permit

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Acknowledgement Required

An approved Permit and a copy of the confined space entry form must be presented if requested by an Authorised Person while on-site at Curtin University.

I confirm that this request to obtain a Confined Space Permit complies with Relevant Legislation and Curtin University Policies.

I have inspected the workplace, have determined and put into place appropriate control measures to minimise health, safety and operational risks, and I agree to accept full responsibility for these risks.

I have downloaded, read and understood the contents of:
Contactor Safety Handbook
Confined Space Permit Guide

I accept and acknowledge all of the above.

Documents Required

All permit requests require the following documents:

Only standard document types accepted. Please name files appropriately.
Combined document file size limit of 14MB.

Attach a Work Methodology

Attach a Risk Management Plan

3. Attach a completed Confined Space Entry pdf

Permit Request Details The Curtin project number or project name

Location and Reason for Access:
(inc. building number, room number and/or other specific access details)

Permit Request Duration

1 day permit

Multi-day permit

Your Details Your Company's Name

Your Name

Your email address. We send important administration notices to this address

Your Contact Number

Curtin Permit Manager Details

Please Note

This is the person who will be responsible for the approval of this permit.
Please make contact with your Curtin Permit Manager about this permit application prior to submitting.

Your Curtin Permit Manager name

The information gathered from this form will be sent to this Curtin email address

Your Curtin Permit Manager phone number

On-Site Contact The Site Contact's name

The Site Contact's job title

The Site Contact's contact number

I confirm that all of the supporting documentation and information contained in this permit request is complete and accurate.

ONLINE PERMITS

Acknowledgement Required

All permit requests require the following documents:

Please Note