Title Page
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Site conducted
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Supervisor
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Coordinator
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Conducted on
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Location
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Team onsite
Light Vehicles
LIGHT VEHICLES & ROADS
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Light Vehicles Inspected
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Asset Number
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Vehicle condition matched prestart
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Photos
Vehicles
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Ongoing LV issues requiring follow up?
Light Vehicle Roads
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Are vehicles using LV roads where required?
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Are observed vehicles complying with site traffic rules?
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Notes
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Photos
Infrastructure
INFRASTRUCTURE
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Parkups & Tie Down Areas
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Area Name
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Area is clean and tidy
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Details
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Adequate lighting is present
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Details
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Comments
Laydowns, Fuel Bays, Misc.
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Area Name
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Area is clean and tidy
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Details
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Adequate lighting is present
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Details
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Comments
Waterstands
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Waterstand Name
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Area is free from ponding water
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Details
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Ground is safe and level for pedestrians
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Details
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Comments
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Photos
Jobs
JOBS
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Development & Other Pit Hygiene Jobs
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Job Name
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What Hazards & Issues Are Present?
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Estimated timeframe for completion
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Photo
Dig Areas
DIG AREAS
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Dig Area
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Area & Dig Unit
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Material Types
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Material?
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Is The Running Track & Floor In Good Condition?
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What Is The Face Condition?
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Face description
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Are There Factors Resulting In Slow Digging
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Are There Specific Hazards/Obstacles Present? Misfires? Bores? Major Oversize? etc.
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Is The Dig Unit Pulling Their Batters On The Fly?
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Additional Comments
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Photos
Dumps
DUMPS & STOCKPILES
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Dump/Stockpile
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Dump Name
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Are Windrows Built To Correct Height, Thickness, and out of Competent Material?
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Is There Visible Cracking, Slumping, or Water Pooling?
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Are Dump Markers Appropriately Placed?
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Is There A Positive Gradient To The Tip Face?
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Are Lighting Plants Suitably Placed To Provide Appropriate Illumination For Night Shift?
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Are Trucks Approaching Tip Head In A Clockwise Direction & Not Using The Windrow To Stop?
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Additional Comments
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Photos
Roads
ROADS
Road Condition
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Are Roads & Intersections Designed To Standard?
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Are Road Suitably Watered?
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Is Delineation & Demarcation Clean & Appropriately Placed?
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Is Visibility At Intersections Obstructed by Windrows, Vegetation, or Other Obstacles?
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Are Bunds And Windrows Built To Correct Height?
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Are There Any Hazards In The Road Surface?
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Details
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Notes
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Photos
General
GENERAL
Hazards
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Are Work Areas Safe From Potential Hazards Above?
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Are Mining Activities Posing Any Risk To Areas Below?
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Are Work Areas Clear Of Spillage?
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Is Effective Dust Control In Place?
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Is Lighting of Active Work Areas Appropriate For Night Shift?
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Areas Not Being Used Windrowed Off As Appropriate?
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All Open Edges Are Appropriately Controlled
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Restricted Areas Demarcated and Access Restricted
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Equipment & Vehicles Parked Fundamentally Stable and In Appropriate Locations (obeying exclusion zones from other equipment, highwalls, etc)
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Clear & Positive Communication Being Used At All Times
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All Delineation, Demarcation, Cones Appropriately Placed & Clean
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Have Any Geotechnical Hazards Been Identified?
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What Are The Geotechnical Hazards?
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Report Geotechnical Hazards To Geotech Engineers
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Additional notes
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Photos
Signoff
SUMMARY AND SIGN OFF
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Additional Comments
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Outgoing Supervisor Signature
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Incoming Supervisor Signature
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Send to Superintendent for approval.
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Superintendent Signature