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ALANGHSE SERVICES
PERIODIC GAS LEVEL CHECK RECORD LFR-F-40F
REV. 01
Controlled Form
STEP 1: REQUISITION / CONTROL INFORMATION
Date2026-08-10 Confined Space Permit No.[ PERMIT_ID ]
Shift A (Time)Start Time: _________ End Time: _________ AM / PM
Shift B (Time)Start Time: _________ End Time: _________ AM / PM
STEP 2: PERMISSIBLE LIMITS (Recycling of Ships Regulations, 2026)
O2 (OXYGEN)CH4 (METHANE) in % H2S (HYDROGEN SULPHIDE) in PPMCO (CARBON MONOXIDE) in PPM
20.6 % to 22.0 % ≤1% of Lower Flammable Limit (LFL) = 0.05% V/V ≤50% of Occupational Exposure Limit [OEL] (5.0 PPM) ≤50% of Occupational Exposure Limit [OEL] (25 PPM)
STEP 3: MULTI-GAS DETECTOR EQUIPMENT
Tick(✓/x)ManufacturerModel Serial NumberCalibrated onNext calibration due on
MSAALTAIR-4X 600649416/02/202615/08/2026
GMIPS241 34879318/03/202618/09/2026
Refer to the applicable Confined Space Entry Permit for the initial (1st) atmospheric readings.
STEP 4: 2nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 3nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 4nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 5nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 6nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 7nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 8nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 4: 9nd/th Reading
ParameterCSADJ-1 ADJ-2ADJ-3ADJ-4
SPACE/LOCATION
O2 [%]
HC* [% LEL]
CO [ppm]
H2S [ppm]
ILLUMINATION
TEMPERATURE
Time
Sign (Inspector)
STEP 5: MANDATORY RULES: Verify atmosphere safe before re-entry. Check gas after each rest break (10.30 AM, 1.00 PM, 3.30 PM or at the prescribed rest breaks or at another formally approved schedule) or whenever the confined space has remained unattended for more than 30 mins. Interval between two consecutive checks should not exceed 90 minutes. CS – Confined Space, ADJ – Adjacent Space, HC – Hydrocarbon.