Muck Wedge and Stope Bag sign off report

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

MUCK WEDGE

• MUCK WEDGE #1 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

• MUCK WEDGE #2 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

• MUCK WEDGE #3 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

• MUCK WEDGE #4 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

• MUCK WEDGE #5 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

• MUCK WEDGE #6 location:

• Remote Mucking Procedure?

  Yes

  No

• Muck Wedge Commissioning report?

  Yes

  No

Stope Bags

• Stope Bag location #1

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Stope Bag location #2

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Stope Bag location #3

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Stope Bag location #4

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Stope Bag location #5

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Stope Bag location #6

• Minimum Ground support policy?

  Yes

  No

• Underground Methane policy?

  Yes

  No

• Updated print of work area with Ground Support Requirements?

  Yes

  No

• Select date

  Date

• Supervisors signature:

  Sign