Title Page

  • Site conducted

  • Date Completed

  • Lead Auditor

  • Audit Participants

  • Event Number

Part 40 - Miner's Representative

  • 30 CFR Reference

  • Does the site have an elected Miner's Representative

  • §40.2 - Has the Miner's Representative completed and filed the required documentation with the local MSHA District?

  • §40.3 - Does the documentation meet the requirements of this section

  • §40.4 - Is a copy of the documentation posted on the mine's bulletin board?

  • Comments & Recommendations

Part 41 - Legal Identity

  • 30CFR Reference

  • §41.10 - Has the site filed a Legal Identity ?

  • §41.11 - Does the Legal Identity contain the required information of this section?

  • §41.12 - Has the Legal Identity been updated within 30 calendar days to reflect site changes?

  • Comments & Recommendations

Part 45 - Independent Contractor Register

  • 30 CFR Reference

  • Does the site employee Independent Contractors?

  • Does the site maintain a register of Independent Contractors?

  • Is the register updated with all current and applicable Independent Contractors?

  • When was the register most recently updated?

  • Does the Independent Contractor register contain: Trade name

  • Does the Independent Contractor register contain: Business address

  • Does the Independent Contractor register contain: Business telephone number

  • Does the Independent Contractor register contain: A description of the nature of work to be performed

  • Does the Independent Contractor register contain: MSHA identification number (if applicable)

  • Does the Independent Contractor register contain: Address of record for service of citations, orders, and documents

  • Comments & Recommendations

Part 47 - Hazardous Communication

  • §47.31 - Does the site have a written HazCom program?

  • When was the HazCom program most recently updated?

§47.32 - HazCom Program Requirements

  • Does the written HazCom program include: A labeling system or other forms of warning

  • Does the written HazCom program include: Methodology for hazard determination

  • Does the written HazCom program include: The use of Material Safety Data Sheets (MSDS) or Safety Data Sheets (SDS) for each hazardous chemical

  • Does the written HazCom program include: A means to access site MSDS or SDS for each hazardous chemical

  • Does the written HazCom program include: Training on the HazCom program requirements and access to chemical safety information

  • Does the written HazCom program include: A list of all hazardous chemicals known to be at the mine

§47.32 - MSDS/SDS Requirements

  • Are MSDS/SDS available for all hazardous chemicals onsite

  • Are MSDS/SDS accessible for all employees, contractors, and site visitors

  • Comments & Recommendations

Part 48 - Training

§48.3/23 - Training Plans

  • Does the site have an MSHA approved training plan(s)?

  • Does the site have more than one approved training plan (Part A and Part B)

  • What is the approval date of the current Part A - Underground plan

  • What is the approval date of the current Part B - Surface plan

  • What is the approval date of the current plan

  • Was the training plan filed and approved by the District Manager in which the mine is located

  • Does the currently approved plan correctly list the person and position of the individual designated responsible for health/safety/training at the site?

  • Is the list of MSHA approved instructors updated and accurate

  • Is the list of Trask Training activities representative of the tasks/work being performed at the site?

§48.9/29 - Training Records

  • Are training records properly completed on MSHA form 5000-23

  • Are training forms 5000-23 accurately filled out and completed according the the training type provided

  • Are training records retained for a minimum of 2 years for current employees

General

  • Are training records well organized

  • Are training records easily accessible

  • Does the site have a system (database, matrix, LMS, etc.) to accurately track miner task training and competencies

  • Comments & Recomendations

Part 49 - Mine Rescue

  • Is this an Underground operation?

§49.2 - Availability Of Mine Rescue Teams

  • Does the site have compliant Mine Rescue coverage through in-house teams, a rescue collective, or an agreement for external emergency services

  • At a minimum, are two teams consisting of 5 members each fully trained and available to respond if necessary

  • Are the responding team's (internal or external) rescue station and equipment located within a two hour ground travel time of the site

  • Has ground transportation been arranged to support the Mine Rescue response to the site

  • Has the local District Manager been sent a statement of compliance regarding the operation's Mine Rescue arrangements

  • Is a copy of the compliance statement posted at the site for miner's to review

§49.5 - Mine Rescue Stations

  • Has the site designated the location of the mine rescue station covering the mine

  • Does the station provide a proper storage environment for the storage of equipment

  • Is stored mine rescue equipment ready for immediate use

§49.6 - Equipment & Maintenance Requirements

General Equpment

  • Does the station have a portable supply of oxygen and carbon dioxide absorbent chemicals to provide a minimum of six hours of use for each Mine Rescue team

  • Does the station have at least one extra fully charged oxygen bottle for every six SCBA's

  • Does the station have a functioning oxygen pump or cascading system for recharging SCBA bottles

  • Does the station have a minimum of twelve functioning permissible cap lamps and chargers

  • Does the station have a minimum of two gas testers with appropriate sensors for each type of gas encountered

  • Does the station have a portable communications system with a minimum 1,000 foot cable/wire

SCBA's

  • Does the station house a minimum of twelve SCBA's

  • Does the station have sufficient spare parts for repairing equipment to ensure operational readiness

  • Are team members trained in the use and care of breathing apparatuses

  • Are SCBA's inspected at intervals of 30 days or less

  • Are inspections certified by the technician including their signature and date the SCBA was serviced

  • Are actions to repair SCBA defects recorded

  • Are records of SCBA repairs maintained for a minimum of one year

§49.7 - Team Member Physicals

  • Are all active team members have valid physical fitness exemptions

  • Are all active team member physicals completed on MSHA form 5000-3

  • Are physical examination records kept on file at the mine rescue station for a minimum of one year

§49.8 - Training Of Mine Rescue Teams

  • Have all active team members completed a minimum 20 induction course on the use, care, and maintained of the utilized SCBA's

  • Have all active team members received at least 40 hours of refresher training within the past twelve months

  • Is training provided 4 hours monthly or 8 hours bi-monthly

  • Have all active team members completed at least two underground training sessions in the past twelve months

  • Have all active team members completed at least six training sessions while wearing/using the SCBA's within the past twelve months

  • Have all active team members completed mine map and ventilation training within the past twelve months

  • Have all training sessions been conducted by MSHA certified instructors

  • Have all training sessions been sufficiently documented to show the training type, subject, duration, and the trainer who provided the instruction

§49.9 - Mine Emergency Notification Plan

  • Does the site have a mine rescue notification plan

  • Does the plan outline the procedures to follow for notifying mine rescue teams when an emergency occurs

  • Is a copy of the mine rescue notification plan posted on the bulletin board

  • Comments & Recommendations

Part 50 - Accident, Injury, and Employment Records

  • Has the site experienced any MSHA reportable accidents or injuries within the past 5 years?

§50.11 - Accident Investigation Reports

  • Has the site prepared an Accident Investigation Report for each occupational injury and immediately reportable event?

  • Do the prepared Accident Investigation Reports contain the nine (9) required sections and corresponding information?

  • Are Accident Investigation reports being retained for a minimum of 5 years?

§50.20 - Accident, Injury, and Illness Reports

  • Has the site submitted MSHA form 7000-1 for all reportable accidents injuries, and illnesses?

  • Were all MSHA 7000-1 documents submitted within 10 working days of the accident or injury date?

  • Are MSHA 7000-1 documents being retained for a minimum of 5 years?

§50.30 - Quarterly Employment Reports

  • Is the site completing MSHA form 7000-2 for employment statistics?

  • Have all from 7000-2 documents been summited within 15 days after the completion of the calendar quarter

  • Is the site retaining documents and/or calculations to demonstrate how 7000-2 reports are generated

  • Comments & Recommendations

Part 56/57 - Subpart B Ground Control

  • Does the site use rock bolts for ground support

  • What types of rock bolts are being used?

  • Has the site obtained the manufacturer's certification for all rock bolt types used (ASTM F432-95)

  • Are mechanically anchored bolts used

  • What types of mechanically anchored bolts are used

  • Is the site recording bolt torque values for the first, every tenth, and last bolt installed on each shift?

  • Are bolts torqued to 50% of the yield point of the bolt or anchorage capacity of the rock

  • Are torque value records available for review

  • Are grouted bolts used

  • Can the grouted bolts be tested by applying torque

  • What types of grouted bolts are being used

  • Is the first fixture installed in each new work place tested and recorded

  • Are grouted bolts tested to withstand 150 foot-pounds of torque

  • Does the site have a way to document corrective actions should grouted bolt torque tests determine bolt failure

  • Are other methods used to determine bolt adequacy

  • What testing methods are used

  • When was the last test completed

  • Are friction bolts used

  • What types of friction bolts are being used

  • Does the site use a methodology to determine the adequacy of friction bolts

  • What methodology does the site use to determine the frequency and location of bolt tests

  • When was the last test conducted

  • Are experienced persons designated by the operator examining and testing ground conditions

  • Are underground haulage/travelways examined weekly

  • Are surface highways and banks adjoining travelways examined weekly

  • Does the site document these weekly inspections

  • How are these inspections documented

Part 56/57 - Subpart C Fire Prevention and Control

§56/57.4201 - Firefighting Equipment Inspections

  • Monthly visual inspections of fire extinguishers are completed?

  • Visual examinations are appropriately certified and dated

  • Annual mechanical inspections of fire extinguishers are completed?

  • Annual inspections are appropriately certified and dated

  • Fire suppression systems are inspected per the manufacturer's specifications

  • What is the manufacturer's specified inspection interval

  • Fire suppression systems inspections are appropriately certified and dated

  • Does the site have a system of pipes, valves, outlets, hydrants, hoses, or other components as part of its firefighting system?

  • Are components of the firefighting system visually inspected every three months

  • Are components use-tested every 12 months

  • Are firefighting system inspections appropriately certified and dated?

§56/57.4330 - Surface Firefighting and Evacuation

  • Has the site established appropriate emergency, firefighting, and evacuation procedures for its surface areas

  • Does the site maintain a fire alarm system and procedure

  • Are surface firefighting and evacuation procedures documented

§56/57.4331 - Surface Firefighting Drills

  • Are employees at the site assigned firefighting responsibilities?

  • Are firefighting drills for assigned employees held at least once every six months

  • Are drills documented

§56/57.4361 - Underground Evacuation Drills

  • Is this an underground operation

  • Are evacuation drills conducted at least once every six months

  • Are drills conducted for all working shifts

  • Are drills appropriately documented and certified

Part 56/57 - Subpart D Air Quality

§56/57.5002 - Exposure Monitoring

  • Is the site conducting air quality monitoring for dust, gas, mist, and fumes miners encounter in the workplace?

  • What possible contaminates does the site actively monitor

  • Is sampling performed frequently enough to determine the adequacy of control measures

  • Are exposure monitoring records well organized and available for review

§56/57.5005 - Exposure Controls

  • Respiratory Protection Standard Z88.2-1969

  • Does the site have an established respiratory protection program?

  • Are all provided respirators NIOSH approved (42CFR Part 84)

  • Does the site have a written respiratory protection program

  • Does the program meet the minimum requirements of ANSI Z88.2-1969

§56/57.5037 - Radon Exposure Monitoring

  • Is this an underground mine?

  • Has the site conducted sampling to determine if radon daughters are present in exhaust air?

  • When was this sampling last completed

  • What was the Radon WL

  • Was the Radon WL less than 0.1 WL

  • Was the Radon WL less than 0.3WL

  • Is the site completing Radon sampling at least every 3 months

  • Is the site completing Radon sampling weekly?

§57.5040 - Radon Exposure Records

  • Has the site found Radon exposure levels above 0.3 WL in active working areas

  • Has the site completed exposure records for all employees working in areas with Radon exposure above 0.3WL

  • Are records document on MSHA form 4000-9 "Record Of Individual Exposure To Radon Daughters"

  • Has the site submitted MSHA form 4000-9 by February 15th of each calendar year

§57.5065 - Diesel Fuel Purchase Records

  • Is this an underground mine

  • Has the site retained purchase records for diesel fuel

  • Do the purchase records show a sulfur content equal to or less than 0.05% (500ppm)

  • Are records retained for at least one year from the date of purchase

§57.5066 - DPM Maintenance Standard

  • Is this an underground mine

  • Does the site retain a log of equipment taken out of service or requiring maintenance related to Diesel Particulate Matter emmissions

  • Does the log include: date equipment was tagged, the date of examination, name of the examiner, and actions taken as a result of the examination

  • Has the site retained the information in the log for a minimum of one year after the equipment was examined

  • Does the site have a list of authorized personnel who are qualified to maintain diesel equipment and their emissions components

  • Are appropriate credentials or evidence of competence available for review

§57.5071 - DPM Exposure Monitoring

  • Is this an underground mine

  • Is the site conducting DPM sampling as necessary to determine the effectiveness of control

  • Has the site posted notice of corrective actions for DPM over exposures on the bulletin board

  • Has the site posted DPM sampling records on the bulletin board

  • Are sample results posted within 15 days of receiving the results

  • Are samples left posted for a minimum of 30 days

  • Has the site retained DPM sampling results for a minimum of 5 years from the date of sampling

Part 56/57 - Subpart E Explosives & 27CFR 555.101

§56/57.6300 - Control Of Blasting Operations

  • Does the site have documented task training or a state issued licensure to authorize employees to perform blasting work

§56/57.6306 - Loading, Blasting, And Security

  • Does the site have a procedure for controlling the blast site during loading and firing

  • Does the site have a procedure for clearing and securing the blast area before initiation

  • Does the site have a procedure for performing a post blast inspection and clearing the affected area

  • Does the site have documentation (task training) for employees who are responsible for conducting a post blast examination

§56/57.6310 - Misfires

  • Does the site have a procedure for evaluating and securing suspected blasting misfires

  • Does the site have a procedure for eliminating an identified blasting misfire

§56/57.6502 - Safety Fuse

  • Is safety fuse used for blasting initiation

  • Is the burn rate of the fuse tested and posted for each new spool of fuse

27CFR 555.101

  • Does the site have a valid and current permit to use explosives

  • What is the current license number

  • When does the current license expire

  • Who is listed as the Responsible Person on the site explosives license

Part 57 - Subpart G Ventilation

  • Is this an underground mine

§57.8520 - Ventilation Plan

  • Does the site have a written ventilation plan containing the required information

  • Mine Name (per Part 41 Legal ID)

  • Mine maps of appropriate scale with all required information

  • Fan data and specifications for all mane and booster fans

  • Diagrams showing how ventilation is accomplished in each typical type of workplace

  • A table of internal combustion engines with applicable information

  • Is the written ventilation plan updated at least annually

  • Date the current plan was issued

§57.8525 - Main Fan Maintenance Logs

  • Does the site perform routine maintenance on the main ventilation fan(s)

  • Does the site have a written maintenance schedule

  • Are maintenance records retained and available for review

Part 56/57 - Subpart J Travelways & Escapeways

  • Is this an Underground Mine

§57.11051 - Escape Routes

  • Does the site conduct regular inspections of underground escape routes

  • Are inspections documented

§57.11053 - Escape And Evacuation Plans

  • Does the site have a documented escape and evacuation plan containing the required information

  • Maps or diagrams displaying required information

  • Procedures on how miners are notified during an emergency

  • Evacuation instructions for each working area of the mine

  • Firefighting plans/procedures

  • Surface procedures for notification of authorities and the preparation of rescue equipment

  • The location and availability of rescue personnel, rescue equipment, emergency power, etc.

  • Assigned responsibilities of all key mine personal during an emergency

  • Is the plan posted at areas of congregation and at shaft stations

  • Is the plan updated with the most recent personnel, site, and evacuation information

  • Date of most recent plan revision

§57.11058 - Check In / Check Out System

  • Has the site established a system to check-in and check-out underground personnel

  • Does the site have a procedure to verify employee headcounts during evacuation, including miners who seek refuge

Part 56/57 - Subpart K Electricity

§56/57.12028-Testing Grounding Systems

  • Does the site have a procedure for testing continuity and resistance of grounding systems

  • Procedure for testing after installation

  • Procedure for testing after repairs are made

  • Procedure after system modifications

  • Procedure for annual testing

  • Does the site have a procedure for identifying portable tools and cords that have been tested annually

  • Does the site have a record of all testing performed under this standard

  • Record of the equipment tested

  • Record of the type of test (installation, repair, modification, or annually)

  • Record of the resistance measured

  • Record of the date of the test

  • Record of the person who conducted the test

Part 56/57 - Subpart L Compressed Air

§56/57.13015-Inspection Of Compressed Air Receivers

  • Does the site have compressed air receiver tanks or pressure vessels

  • Does the site have an updated list of all compressed air receivers and pressure vessels that are required to be inspected

  • Does the site have records of inspection for all compressed air receivers and pressure vessels

  • All all inspection records valid and completed before the expiration of the previous inspection record (if applicable)

§56/57.13017-Compressor Discharge Pipes

  • Does the site have air compressors that may create carbon build up in the discharge pipes

  • Is the discharge piping cleaned periodically per the manufacturer's recommendations or at least every two years

  • Are cleaning records documented and available for review

§56/57.13030-Fired Pressure Vessels (Boilers)

  • Does the site have fired pressure vessels (boilers)

  • Does the site have an updated list of all boilers that are required to be inspected

  • Does the site have records of inspection for all boilers

  • All all inspection records valid and completed before the expiration of the previous inspection record (if applicable)

Part 56/57-Subpart M Machinery & Equipment

§56/57.14100-Safety Defects, Examination, Correction, and Records

  • Does the site have a system for employees to perform pre-shift inspections of mobile equipment

  • Does the site have a system for removing defective equipment from service

  • Does the site have a system to record equipment defects until the defects are corrected

Part 56/57-Subpart Q Safety Programs

§56/57.18002-Workplace Examinations

  • Has the site trained and designated competent persons to examine working places before work begins

  • Does the site have a system to promptly notify miners in the affected area of adverse conditions identified during examination

  • Does the site have a record of examination that contains the minimum required information (name, date, location, and adverse conditions found)

  • Does the site have a system in place to include or supplement the examination record to include the date of corrective action for identified adverse conditions

  • Are examination records maintained for a minimum of 1 year from the date of the examination

§56/57.18009-Designation Of Person in Charge

  • Has the site designated a person in charge on each shift to be responsible in the event of an emergency

§56/57.18010-First Aid

  • Is an individual capable of providing First Aid available on each working shift

  • Does the site make First Aid training available to all interested miners

§56/57.18012-Emergency Telephone Numbers

  • Does the site have a list of emergency contact numbers

  • Is the list posted at appropriate locations (telephones, break rooms, etc.)

  • Is the list updated to reflect current site staffing, emergency personnel, and outside response services

§56/57.18014-Emergency Medical Assistance & Transportation

  • Has the site made advanced arrangements for receiving medical assistance and the transportation of injured miners

§56/57.18020-Working Alone

  • Does the site have a policy or procedure in place to ensure miners are not working alone without communication

Pat 56/57-Subpart R Personnel Hoisting

  • Does this mine use hoists for the transportation of personnel, supplies, or equipment?

§56/57.19001- Rated Capacities

  • Does all hoisting equipment have a documented rated capacity?

  • Are rated capacities consistent with the loads handled?

§56/57.19022-Rope Measurements

  • Is the diameter of newly installed rope (post initial stretch) being measured?

  • Are measurements taken in every third interval of active rope length and averaged?

  • Are records of measurements certified by the person(s) completing the measurements?

  • Are the records retained until the rope is retired from service?

§56/57.19120-Procedures For Inspection, Testing, And Maintenance

  • Has a procedure for the inspection, testing, and maintenance of hoisting equipment been developed?

  • Is the adopted procedure being followed?

  • Does the procedure capture the necessary inspections and tests required to adequality maintain and ensure the safe functionality of the hoisting equpment?

  • What deficiencies were observed?

§56/57.19121-Recordkeeping

  • Are records of all inspections, tests, and maintenance kept and available for review?

  • Are records certified by the person(s) performing the inspections, tests, and maintenance? (Name, Signature, Date)

  • Are records retained for a minimum of one calendar year?

Part 56/57-Subpart S Miscellaneous

§56/57.20001-Intoxicating Beverages & Narcotics

  • Does the site have a policy or program in place to prohibit the use of alcohol and drugs onsite

  • Does the site have a program or policy in place to randomly test employees for alcohol and drug use

§56/57.20009-Tests For Explosive Dusts

  • Does the site have any work produced or liberated dusts that are potentially explosive

  • Have the dusts been tested for explosibility

  • Date of the last test

  • Did the tests identify a potential explosive hazard

  • Have controls been put in place to mitigate potential hazards

Part 62-Hearing Conservation

§62.110(a)-Noise Exposure Assessment

  • Has the site established a system to evaluate each miner's noise expsoure

  • Is the miner's dose exposure made without adjustment for hearing protection

§62.110(d)-Miner Notification

  • Does the site have a process of notifying the miner if their noise exposure exceeds the action level or PEL

  • Does the notification include the required information (exposure determination and corrective actions)

  • Are notifications provided within 15 days of the exposure determination

  • Does the site retain copies of the miner's notification for the duration of the miner's exposure at or above the action level

§62.130-Permissible Exposure Level

  • Are miners exposure to sound levels above the PEL enrolled in a Hearing Conservation Program

  • Does the site use administrative controls to reduce miner's exposure to noise

  • Are the identified administrative controls posted on the site's bulletin board

  • Have the affected miners been provided copies of the administrative controls

§62.150-Hearing Conservation Program

  • Does the site have a written Hearing Conservation Program (HCP)

  • Does the HCP include the required sections

  • System for monitoring miner's noise exposure

  • The provision, training, and use of hearing protectors

  • Audiometric testing

  • Training

  • Documentation and recordkeeping

§62.170-Audiometric Testing

  • Does the site have a system in place to provide audiometric testing to miners enrolled in the HCP

  • Are baseline audiograms completed within 6 months of HCP enrollment (or 12 months if mobile testing services are used)

  • Are subsequent audiometric tests completed within 12 months of the baseline or the previous test

§62.174-Standard Threshold Shift Corrective Measures

  • Has the site recorded any Standard Threshold Shifts (STS)

  • Has the miner been retrained

  • Has the miner been provided an opportunity to select different hearing protection

  • Has the site reviewed and documented the effectiveness of engineering and administrative controls that may contribute to the STS

  • Have all requirements been completed within 30 days of notification of the STS

§62.175-Notification Of Results & Reporting

  • Has the site provided within 10 days notification of results regarding a follow up evaluation

  • Does the notification include the required information (results and interpretation and reasons for further texting if applicable)

  • Has the site reported to MSHA any incurred reportable hearing loss as required by Part 50

§62.180-Training

  • Has the site provided HCP training to enrolled miners

  • Was training provided within 30 days of enrollment

  • Does the site provide re-training to miners at least every 12 months after the completion of their initial training

  • Are training records documented to demonstrate compliance with this section

General Observations

  • Are MSHA records and documents well organized

  • General Comments

  • Are MSHA records and documents easily accessible

  • General Comments

  • Does site staff know where to access MSHA documents and records

  • General Comments

  • Other Comments & Observations

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