SafetyCulture Staff

Mining Maintenance Notification Form

Use this form to log maintenance requests related to safety and quality hazards on a mine site.

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Title Page

Audit Title
Location
Project / Site
Conducted on
Prepared by

Please log all maintenance notifications and requests below

Maintenance Notification / Request

Notification / Request Type
Describe request and findings
Location of request (please be detailed)
Log all applicable corrective Actions to the item above, and assign to the responsible team member
Supporting photographs (if applicable)

Sign Off

Full name and signature of auditor

SafetyCulture Staff

Mining Maintenance Notification Form

Use this form to log maintenance requests related to safety and quality hazards on a mine site.

Use this Template

Print as PDF

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.