CCMP UNDERGROUND

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1 HOT WORK

• WORK AREA [name]

1.1 DESIGNATED, APPROVED HOT WORK AREA

• 1.1.1 Designated, approved hot work area

  Yes

  No

  N/A

• 1.1.2 Area map showing hot work area

  Yes

  No

  N/A

• 1.1.3 Hot Work Area Inspection Log available

  Yes

  No

  N/A

• 1.1.4 Monthly inspection performed (check inspection log)

  Yes

  No

  N/A

1.2. HOT WORK AREA (permanent & temporary)

• 1.2.1 Area clear of combustibles

  Yes

  No

  N/A

• 1.2.2 Area clear demarcated

  Yes

  No

  N/A

• 1.2.3 Area isolated and contained

  Yes

  No

  N/A

• 1.2.4 Fire suppressing systems (incl. fire extinguisher) available

  Yes

  No

  N/A

• 1.2.5 Fire extinguisher inspected - monthly and annually

  Yes

  No

  N/A

• 1.2.6 No flammables / explosives within 10 m

  Yes

  No

  N/A

• 1.2.7 Adequate signage available

  Yes

  No

  N/A

• 1.2.8 Hot work area map visible

  Yes

  No

  N/A

• 1.2.9 Housekeeping adequate in area

  Yes

  No

  N/A

• 1.2.10 Tools properly stored

  Yes

  No

  N/A

1.3 HOT WORK PERMIT (for work conducted outside designated, approved hot work area)

• 1.3.1 Name of employee [First & last name]

• 1.3.2 Hot work permit (valid?)

  Yes

  No

  N/A

• 1.3.3 Supervisor sign-off

  Yes

  No

  N/A

• 1.3.4 Fire watch

  Yes

  No

  N/A

• 1.3.5 Risk assessment (JHA, TBRA)

  Yes

  No

  N/A

2 ELECTRICAL WORK

• WORK AREA

• NAME of EMPLOYEE [First & last name]

• 2.1 Electrical Shock and ArcFlash Hazard Analysis Form completed

  Yes

  No

  N/A

• 2.2 Supervisor sign-off

  Yes

  No

  N/A

• 2.3 Risk assessment (JHA)

  Yes

  No

  N/A

3 HEAT BLANKETS ON TURBOS AND EXHAUSTS

• WORK AREA

• VEHICLE ID#

• 3.1 Heat blanket on turbo

  Yes

  No

  N/A

• 3.2 Heat blanket on exhaust

  Yes

  No

  N/A

4 VEHICLES & DRIVING

• VEHICLE IDENTIFICATION NUMBER [ID #]

• ID# - Front

  Big

  Small

  No ID#

• ID# - Driver side

  Big

  Small

  No ID#

• ID# - Back

  Big

  Small

  No ID#

• ID# - Passenger side

  Big

  Small

  No ID#

• DRIVER [First & last name]

• OBSERVATION: If applicable, break test performed before entering mine

  Yes

  No

  N/A

• Seat belt

  Yes

  No

  N/A

• Buggy whip (illuminated)

  Yes

  No

  N/A

• Beacon (fully functional)

  Yes

  No

  N/A

• Fire extinguisher

  Yes

  No

  N/A

• Fire extinguisher - MONTHLY inspection

  Yes

  No

  N/A

• Fire extinguisher - ANNUAL Inspection

  Yes

  No

  N/A

• Extension cord

  Yes

  No

  N/A

• Extension cord - QUARTERLY inspection (1. Yellow, 2. Blue, 3. Green, 4. Red)

  Yes

  No

  N/A

• Cleanliness (compliant with visual standard)

  Yes

  No

  N/A

• Radio - fully functional

  Yes

  No

  N/A

• Radio - Low watt radio

  Yes

  No

  N/A

• Radio - Does the driver know the radio channel for the ramp (# 43)

  Yes

  No

  N/A

• Radio - Does the driver know the radio channel for CODE 1 (# 1 emergency)

  Yes

  No

  N/A

• LOG BOOK: Entry for today

  Yes

  No

  N/A

• LOG BOOK: Supervisor sign-off

  Yes

  No

  N/A

• LOG BOOK: White copies removed

  Yes

  No

  N/A

• COMMENTS

5 FIRE EXTINGUISHER

• Location

• Monthly inspection

  Yes

  No

  N/A

• Annual inspection

  Yes

  No

  N/A

• Serial number

  Yes

  No

  N/A