Mock MSHA Audit (H&S Detail Version)

Location Information

• Site conducted

  Select

• Operating Division

  Select

• Areas Inspected

  Select

• What Business Partners Were Audited?

• Areas Inspected

  Select

• Areas Inspected

  Select

• What Areas Were Inspected?

• Date Completed

  Date

• Lead Auditor

• Audit Participants

• Event Number

Observation

• Hazard Type

  Select Unsafe Act Unsafe Condition Policy Violation

  • Unsafe Act
  • Unsafe Condition
  • Policy Violation

• Priority

  High

  Medium

  Low

• Description

• FPC Violation

  Yes

  No

  N/A

• Which FPC was violated

  Select #1-Competent, Capable & Controlled #2-Identify & Control Hazards #3-Mobile Equipment & Light Vehicles #4-Energy Isolation & Electrical Work #5-Working At Heights #6-Cranes & Hoists #7-Confiend Space #8-Engulfment/Entrapment #9-Equipment Safeguards & Protective Devices #10-Chemical & Hazardous Substance

  • #1-Competent, Capable & Controlled
  • #2-Identify & Control Hazards
  • #3-Mobile Equipment & Light Vehicles
  • #4-Energy Isolation & Electrical Work
  • #5-Working At Heights
  • #6-Cranes & Hoists
  • #7-Confiend Space
  • #8-Engulfment/Entrapment
  • #9-Equipment Safeguards & Protective Devices
  • #10-Chemical & Hazardous Substance

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

• 30CFR - Part 47 - Hazard Communication

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

• 30CFR - Part 48 - Training Of Miners

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

• 30CFR - Part 49 - Mine Rescue

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart B - Ground Control

• 30CFR - Part 56/57 - Subpart B Ground Control

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart C - Fire Prevention & Control

• 30CFR - Part 56/57 - Subpart C Fire Prevention

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart D - Air Quality & DPM

• 30CFR - Part 56/57 - Subpart D Air Quality & DPM

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart E - Explosives

• 30CFR - Part 56/57 - Subpart E Explosives

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart F - Drilling & Rotary Jet Piercing

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart G - Ventilation

• 30CFR - Part 56/57 - Subpart G Ventilation

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart H - Loading, Hauling, & Dumping

• 30CFR - Part 56/57 - Subpart H Loading, Hauling, Dumping

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart J - Travelways & Escapeways

• 30CFR - Part 56/57 - Subpart J Travelways & Escapeways

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart K - Electricity

• 30CFR - Part 56/57 - Subpart K Electricity

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart L - Compressed Air & Boilers

• 30CFR - Part 56/57 - Subpart L Compressed Air & Boilers

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart M - Machinery & Equipment

• 30CFR - Part 56/57 - Subpart M Machinery & Equipment

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart N - Personal Protection

• 30CFR - Part 56/57 - Subpart N Personal Protection

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart O - Materials Storage & Handling

• 30CFR - Part 56/57 - Subpart Materials Storage & Handling

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart P - Illumination

• 30CFR - Part 56/57 - Subpart P Illumination

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart Q - Safety Programs

• 30CFR - Part 56/57 - Subpart Q Safety Programs

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart R - Personnel Hoisting

• 30CFR - Part 56/57 - Subpart R Personnel Hoisting

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

Subpart S - Miscellaneous

• 30CFR - Part 56/57 - Subpart S Miscellaneous

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media

• 30CFR - Part 62 - Occupational Noise Exposure

Observation

• Hazard Type

  Unsafe Act

  Unsafe Condition

  Policy Violation

• Priority

  High

  Medium

  Low

• Description

• 30 CFR Reference Part/Section

• Cited Regulation Text

• Likelihood

  No Liklihood

  Unlikely

  Reasonably Likely

  Highly Likely

  Occurred

• Expected Injury

  Select No Lost Workdays Lost Workday or Restricted Duty Permanently Disabling Fatal

  • No Lost Workdays
  • Lost Workday or Restricted Duty
  • Permanently Disabling
  • Fatal

• Significant & Substantial

  Yes

  No

• Number Of Persons Affected

• Negligence

  None

  Low

  Moderate

  High

  Reckless Disregard

• Has The Hazard Been Corrected

  Yes

  No

• Steps Taken To Mitigate The Hazard

• Photographs

  Media