Title Page

  • Report composed:

  • Prepared by:

Report

Inspection Details:

  • Crew:

  • Shift:

  • Start:

  • Finish:

  • Inspection Area:

Checklist:

  • MOBILE EQUIPMENT:

  • Are active haul circuit intersections compliant with the Haul Road Design Procedure?

  • Actions/Comments:

  • Photographs:

  • Are active haul roads compliant with the Haul Road Design Procedure?

  • Actions/Comments:

  • Photographs:

  • Are there any single lane access points on hauls circuits? If yes list controls.

  • Actions/Comments:

  • Photographs:

  • Have safe parking areas for light vehicles been provided at all dig and dump locations?

  • Actions/Comments:

  • Photographs:

  • ELECTRICAL SAFETY

  • Are all cable towers spaced at a suitable distance in accordance with the procedure?

  • Actions/Comments:

  • Photographs:

  • Are all cables demarcated in the appropriate areas?

  • Actions/Comments:

  • Photographs:

  • STRATA FAILURE

  • Has a High Wall Low Wall Access Permit been completed for workers working within 10m of the toe or crest?

  • Actions/Comments:

  • Photographs:

  • Are windrows of suitable height erected along roadways, highwalls and dumps?

  • Actions/Comments:

  • Photographs:

  • Are dump TARP signs positioned at all working dumps?

  • Actions/Comments:

  • Photographs:

  • Are there any water related issues (e.g. water pooling at pit wall crest or dump toe)?

  • Actions/Comments:

  • Photographs:

  • Are pit walls dug to design, stable, of correct batter and free from undercutting?

  • Actions/Comments:

  • Photographs:

  • FIRE AND EXPLOSION / EXPLOSIVES AND SHOTFIRING

  • Are there any signs of Spon Com or heating?

  • Actions/Comments:

  • Photographs:

  • Are there any sleeping or loaded shots in your district?

  • Actions/Comments:

  • Photographs:

  • Are there any misfires in your inspection district and have they been demarcated?

  • Actions/Comments:

  • Photographs:

  • ENVIRONMENT AND COMMUNITY

  • Is roadway dust to acceptable limits?

  • Actions/Comments:

  • Photographs:

  • Are any lighting plants directed towards community sensitive receptors (visible off site)?

  • Actions/Comments:

  • Photographs:

  • Have there been any noise and dust alarms throughout the shift?

  • Actions/Comments:

  • Photographs:

Report:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

  • Area Inspected:

  • Activity:

  • Risk:

  • Actions /Comments:

  • Inspection Frequency Hrs:

Risk Management:

  • Notes:

  • TARP Level 3 (Red) activation?

  • Comment:

  • Intersection/Traffic Condition Changes:

  • Reference Report No:

  • GCOM Slide?:

  • Incidents:

  • Immediate Actions / Controls Implemented:

  • Hazards Raised:

  • Improvements:

  • Photograph of improvement area:

Signoff

  • Signature : Off Going

  • Open Cut Examiner :

  • I the above signed have inspected areas and activities under my control pursuant to the Work Health and Safety (Mines) Act 2013 and Regulation 2014.

    The inspection has been in accordance with the Mine Inspection Procedure & I certify that this document is a full & accurate report of any observed exceptions which may affect the safety of persons in those areas.

  • Signature Countersign : On Coming

  • Open Cut Examiner :

  • I the above signed have reviewed the inspection report and communicated the content of the report to workers of the oncoming shift in accordance with the Work Health and Safety (Mines) Act 2013 and Regulation 2014.

  • Signature : Off Going

  • Senior Open Cut Examiner :

  • I the undersigned have reviewed the assessment of risk to determine the inspection frequency for the work area and deem the report accurate.

  • Signature :

  • Mining Engineering Manager/Delegate :

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.