Information
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Prepared by:
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Date
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Select shift
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Is this inspection being performed at the Maintenance area /
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Additional comments
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All of the following should be checked during the inspections (if applicable)<br>*Eyewash/Showers (w/cards) *Guards *Electrical Hazards *PPE *Slip, Trip & Fall Hazards<br>*Lighting *House Keeping *Trash cans *Fire Extinguishers *First Aid. <br> Any adverse conditions found?
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Take picture of the adverse condition(s)
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Notification to Miner’s Working in the Area?
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Notification to Supervisor or Manager?
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Is there a WO submitted? if so, enter the WO number
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Enter WO number
Corrective Actions (if any)
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Enter the Date when adverse conditions were corrected. Add any comment (if needed)
