• Name of Mine Site

  • Workplace/Stope Location:

  • Date Inspected:

  • Date Required:

  • Date Stope Prep. Completed:

Job Site Inspection Sheet


  • Is Air Pressure and Volume in good condition?

  • Is a Water Trap required?

  • Are Water Pressure and Volume up to standard?

  • Are Headers Close Enough with Proper Fittings?

  • Are Slide/Bucket/Ladders in good condition?

  • Is Ventilation up to standard?

  • Is there Suitable Power Supply (Poper Ground Fault)?

  • Are Communications up to standard?


  • Access to work area safe?

  • Immediate work area safe? Scaled?

  • Communication Installed?

  • Adequate ground support?


  • Are Prints and Layouts up to standard?

  • Are Lines Marked Up correctly?

  • Adequate Drift Height

  • What is the height?

  • Aqequate Drift Width

  • What is the width?


  • Clean floor? / Level?

  • How much muck on floor?

  • Casing needed?

  • Long steel for collaring upholes?

  • "PAD" required for back height?

  • Burm required for back height?

  • Drilling material required?

  • Bulkheads, Fencing, Signs in Place

  • Cell Supervisor:

  • Boart Supervisor:

  • Cell Planner:

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.