GRO-2678-FRM-Weekly SSE Inspection

Weekly SSE Inspection Form

• Conducted on

  Date

• Mine Areas Inspected:

• Prepared by

Mine Area:

• Location:

• Person Responsible For Area:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Responsible Person:

• Due Date:

  Date

• Action 2:

• Responsible Person:

• Due Date:

  Date

Mine Area:

• Location:

• Person Responsible For Area:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Responsible Person:

• Due Date:

  Date

• Action 2:

• Responsible Person:

• Due Date:

  Date

Mine Area:

• Location:

• Person Responsible For Area:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Responsible Person:

• Due Date:

  Date

• Action 2:

• Responsible Person:

• Due Date:

  Date

Mine Area:

• Location:

• Person Responsible For Area:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Responsible Person:

• Due Date:

  Date

• Action 2:

• Responsible Person:

• Due Date:

  Date

Ventilation & Gas Management:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Person Responsible:

• Due Date:

  Date

• Action 2:

• Person Responsible:

• Due Date:

  Date

Coal Dust Control & Stonedust Standards:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Person Responsible:

• Due Date:

  Date

• Action 2:

• Person Responsible:

• Due Date:

  Date

Compliance to Standards & Procedures:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Person Responsible:

• Due Date:

  Date

• Action 2:

• Person Responsible:

• Due Date:

  Date

Interactions with Regulators:

• Comments:

• Add media

  Media

• Corrective Actions?

  Yes

  No

• Action 1:

• Person Responsible:

• Due Date:

  Date

• Action 2:

• Person Responsible:

• Due Date:

  Date

Inspection Completed:

• Add signature

  Sign

• Comments: