This document should be used to support the general requirements of
The Greencore Group Permit to Work 03.200.she.

It is intended to facilitate a "Safe System of Work"
where Entry into a Confined Space is necessary to complete the work activity.

What is a Confined Space
(The Confined Spaces Regulations 1997)

Any place, including any chamber, tank, vat, silo, pit, trench, pipe, sewer, flu, well or other similar space in which, by virtue of its enclosed nature, there rises a reasonably foreseeable specified risk (See 03.206.she definition of specified risk).

What confined space is it?

Where is the confined space?

ALL CONFINED SPACES MUST BE MONITORED AT THE BEGINNING OF EACH SHIFT
OR AFTER FOUR (04) HOURS WHICHEVER COMES SOONER.

Date of test	Oxygen level O2	Explosive level (LEL)	Toxicity	Time	Print Name of Supervisor

This confined space entry permit was first issued on _ _/_ _/ _ _ by I have read and understand the company risk assessment concerning confined space entry. I can confirm that at the time of issue of this confined space permit the criteria outlined in the Company risk assessment for confined space entry has been met. A Safe System of Work exists and if these conditions change the Permit to Enter a Confined Space will be withdrawn immediately. Signature of person initially authorising confined space entry I have withdrawn this Confined Space Entry Permit because (DELETE AS APPROPRIATE):

The work is now complete and all personnel have been accounted for and withdrawn. The oxygen level was unacceptable e.g. below 20.9%. Above 20.9% The Lower Explosive Limit was unacceptable. The Upper Explosive Limit was unacceptable The level of toxicity was unacceptable. Another hazard existed which I have outlined below:   PRINT NAME of person withdrawing Confined space permit: JOB TITLE Date of withdrawal _ _/_ _/_ _.