Title Page

Location Information

  • Site conducted

  • Operating Division

  • Areas Inspected

  • What Business Partners Were Audited?

  • Areas Inspected

  • Areas Inspected

  • What Areas Were Inspected?

  • Date Completed

  • Lead Auditor

  • Audit Participants

  • Event Number

Non-Regulatory Observations

    Observation
  • Hazard Type

  • Priority

  • Description

  • Critical Risk Prevention Violation?

  • Which CRP Was Violated?

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Part 47 - Hazard Communication

  • 30CFR - Part 47 - Hazard Communication

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Part 48 - Training Of Miners

  • 30CFR - Part 48 - Training Of Miners

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Part 49 - Mine Rescue

  • 30CFR - Part 49 - Mine Rescue

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Part 56/57 - Safety & Health Standards

Subpart B - Ground Control

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart C - Fire Prevention & Control

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart D - Air Quality & DPM

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart E - Explosives

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart F - Drilling & Rotary Jet Piercing

    Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart G - Ventilation

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart H - Loading, Hauling, & Dumping

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart J - Travelways & Escapeways

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart K - Electricity

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart L - Compressed Air & Boilers

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart M - Machinery & Equipment

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart N - Personal Protection

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart O - Materials Storage & Handling

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart P - Illumination

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart Q - Safety Programs

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart R - Personnel Hoisting

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Subpart S - Miscellaneous

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

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

Part 62 - Occupational Noise Exposure

  • 30CFR - Part 62 - Occupational Noise Exposure

  • Observation
  • Hazard Type

  • Priority

  • Description

  • 30 CFR Reference Part/Section

  • Cited Regulation Text

  • Likelihood

  • Expected Injury

  • Significant & Substantial

  • Number Of Persons Affected

  • Negligence

  • Has The Hazard Been Corrected

  • Steps Taken To Mitigate The Hazard

  • Photographs

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.