Title Page
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Site conducted
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Date Completed
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Lead Auditor
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Audit Participants
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Event Number
Part 40 - Miner's Representative
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30 CFR Reference
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Does the site have an elected Miner's Representative
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§40.2 - Has the Miner's Representative completed and filed the required documentation with the local MSHA District?
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§40.3 - Does the documentation meet the requirements of this section
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§40.4 - Is a copy of the documentation posted on the mine's bulletin board?
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Comments & Recommendations
Part 41 - Legal Identity
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30CFR Reference
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§41.10 - Has the site filed a Legal Identity ?
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§41.11 - Does the Legal Identity contain the required information of this section?
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§41.12 - Has the Legal Identity been updated within 30 calendar days to reflect site changes?
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Comments & Recommendations
Part 45 - Independent Contractor Register
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30 CFR Reference
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Does the site employee Independent Contractors?
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Does the site maintain a register of Independent Contractors?
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Is the register updated with all current and applicable Independent Contractors?
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When was the register most recently updated?
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Does the Independent Contractor register contain: Trade name
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Does the Independent Contractor register contain: Business address
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Does the Independent Contractor register contain: Business telephone number
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Does the Independent Contractor register contain: A description of the nature of work to be performed
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Does the Independent Contractor register contain: MSHA identification number (if applicable)
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Does the Independent Contractor register contain: Address of record for service of citations, orders, and documents
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Comments & Recommendations
Part 47 - Hazardous Communication
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§47.31 - Does the site have a written HazCom program?
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When was the HazCom program most recently updated?
§47.32 - HazCom Program Requirements
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Does the written HazCom program include: A labeling system or other forms of warning
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Does the written HazCom program include: Methodology for hazard determination
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Does the written HazCom program include: The use of Material Safety Data Sheets (MSDS) or Safety Data Sheets (SDS) for each hazardous chemical
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Does the written HazCom program include: A means to access site MSDS or SDS for each hazardous chemical
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Does the written HazCom program include: Training on the HazCom program requirements and access to chemical safety information
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Does the written HazCom program include: A list of all hazardous chemicals known to be at the mine
§47.32 - MSDS/SDS Requirements
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Are MSDS/SDS available for all hazardous chemicals onsite
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Are MSDS/SDS accessible for all employees, contractors, and site visitors
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Comments & Recommendations
Part 48 - Training
§48.3/23 - Training Plans
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Does the site have an MSHA approved training plan(s)?
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Does the site have more than one approved training plan (Part A and Part B)
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What is the approval date of the current Part A - Underground plan
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What is the approval date of the current Part B - Surface plan
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What is the approval date of the current plan
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Was the training plan filed and approved by the District Manager in which the mine is located
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Does the currently approved plan correctly list the person and position of the individual designated responsible for health/safety/training at the site?
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Is the list of MSHA approved instructors updated and accurate
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Is the list of Trask Training activities representative of the tasks/work being performed at the site?
§48.9/29 - Training Records
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Are training records properly completed on MSHA form 5000-23
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Are training forms 5000-23 accurately filled out and completed according the the training type provided
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Are training records retained for a minimum of 2 years for current employees
General
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Are training records well organized
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Are training records easily accessible
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Does the site have a system (database, matrix, LMS, etc.) to accurately track miner task training and competencies
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Comments & Recomendations
Part 49 - Mine Rescue
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Is this an Underground operation?
§49.2 - Availability Of Mine Rescue Teams
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Does the site have compliant Mine Rescue coverage through in-house teams, a rescue collective, or an agreement for external emergency services
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At a minimum, are two teams consisting of 5 members each fully trained and available to respond if necessary
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Are the responding team's (internal or external) rescue station and equipment located within a two hour ground travel time of the site
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Has ground transportation been arranged to support the Mine Rescue response to the site
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Has the local District Manager been sent a statement of compliance regarding the operation's Mine Rescue arrangements
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Is a copy of the compliance statement posted at the site for miner's to review
§49.5 - Mine Rescue Stations
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Has the site designated the location of the mine rescue station covering the mine
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Does the station provide a proper storage environment for the storage of equipment
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Is stored mine rescue equipment ready for immediate use
§49.6 - Equipment & Maintenance Requirements
General Equpment
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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
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Does the station have at least one extra fully charged oxygen bottle for every six SCBA's
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Does the station have a functioning oxygen pump or cascading system for recharging SCBA bottles
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Does the station have a minimum of twelve functioning permissible cap lamps and chargers
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Does the station have a minimum of two gas testers with appropriate sensors for each type of gas encountered
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Does the station have a portable communications system with a minimum 1,000 foot cable/wire
SCBA's
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Does the station house a minimum of twelve SCBA's
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Does the station have sufficient spare parts for repairing equipment to ensure operational readiness
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Are team members trained in the use and care of breathing apparatuses
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Are SCBA's inspected at intervals of 30 days or less
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Are inspections certified by the technician including their signature and date the SCBA was serviced
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Are actions to repair SCBA defects recorded
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Are records of SCBA repairs maintained for a minimum of one year
§49.7 - Team Member Physicals
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Are all active team members have valid physical fitness exemptions
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Are all active team member physicals completed on MSHA form 5000-3
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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
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Have all active team members completed a minimum 20 induction course on the use, care, and maintained of the utilized SCBA's
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Have all active team members received at least 40 hours of refresher training within the past twelve months
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Is training provided 4 hours monthly or 8 hours bi-monthly
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Have all active team members completed at least two underground training sessions in the past twelve months
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Have all active team members completed at least six training sessions while wearing/using the SCBA's within the past twelve months
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Have all active team members completed mine map and ventilation training within the past twelve months
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Have all training sessions been conducted by MSHA certified instructors
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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
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Does the site have a mine rescue notification plan
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Does the plan outline the procedures to follow for notifying mine rescue teams when an emergency occurs
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Is a copy of the mine rescue notification plan posted on the bulletin board
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Comments & Recommendations
Part 50 - Accident, Injury, and Employment Records
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Has the site experienced any MSHA reportable accidents or injuries within the past 5 years?
§50.11 - Accident Investigation Reports
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Has the site prepared an Accident Investigation Report for each occupational injury and immediately reportable event?
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Do the prepared Accident Investigation Reports contain the nine (9) required sections and corresponding information?
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Are Accident Investigation reports being retained for a minimum of 5 years?
§50.20 - Accident, Injury, and Illness Reports
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Has the site submitted MSHA form 7000-1 for all reportable accidents injuries, and illnesses?
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Were all MSHA 7000-1 documents submitted within 10 working days of the accident or injury date?
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Are MSHA 7000-1 documents being retained for a minimum of 5 years?
§50.30 - Quarterly Employment Reports
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Is the site completing MSHA form 7000-2 for employment statistics?
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Have all from 7000-2 documents been summited within 15 days after the completion of the calendar quarter
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Is the site retaining documents and/or calculations to demonstrate how 7000-2 reports are generated
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Comments & Recommendations
Part 56/57 - Subpart B Ground Control
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Does the site use rock bolts for ground support
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What types of rock bolts are being used?
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Has the site obtained the manufacturer's certification for all rock bolt types used (ASTM F432-95)
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Are mechanically anchored bolts used
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What types of mechanically anchored bolts are used
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Is the site recording bolt torque values for the first, every tenth, and last bolt installed on each shift?
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Are bolts torqued to 50% of the yield point of the bolt or anchorage capacity of the rock
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Are torque value records available for review
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Are grouted bolts used
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Can the grouted bolts be tested by applying torque
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What types of grouted bolts are being used
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Is the first fixture installed in each new work place tested and recorded
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Are grouted bolts tested to withstand 150 foot-pounds of torque
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Does the site have a way to document corrective actions should grouted bolt torque tests determine bolt failure
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Are other methods used to determine bolt adequacy
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What testing methods are used
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When was the last test completed
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Are friction bolts used
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What types of friction bolts are being used
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Does the site use a methodology to determine the adequacy of friction bolts
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What methodology does the site use to determine the frequency and location of bolt tests
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When was the last test conducted
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Are experienced persons designated by the operator examining and testing ground conditions
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Are underground haulage/travelways examined weekly
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Are surface highways and banks adjoining travelways examined weekly
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Does the site document these weekly inspections
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How are these inspections documented
Part 56/57 - Subpart C Fire Prevention and Control
§56/57.4201 - Firefighting Equipment Inspections
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Monthly visual inspections of fire extinguishers are completed?
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Visual examinations are appropriately certified and dated
- Compliant
- Non-Compliant
- NA
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Annual mechanical inspections of fire extinguishers are completed?
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Annual inspections are appropriately certified and dated
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Fire suppression systems are inspected per the manufacturer's specifications
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What is the manufacturer's specified inspection interval
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Fire suppression systems inspections are appropriately certified and dated
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Does the site have a system of pipes, valves, outlets, hydrants, hoses, or other components as part of its firefighting system?
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Are components of the firefighting system visually inspected every three months
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Are components use-tested every 12 months
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Are firefighting system inspections appropriately certified and dated?
§56/57.4330 - Surface Firefighting and Evacuation
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Has the site established appropriate emergency, firefighting, and evacuation procedures for its surface areas
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Does the site maintain a fire alarm system and procedure
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Are surface firefighting and evacuation procedures documented
§56/57.4331 - Surface Firefighting Drills
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Are employees at the site assigned firefighting responsibilities?
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Are firefighting drills for assigned employees held at least once every six months
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Are drills documented
§56/57.4361 - Underground Evacuation Drills
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Is this an underground operation
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Are evacuation drills conducted at least once every six months
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Are drills conducted for all working shifts
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Are drills appropriately documented and certified
Part 56/57 - Subpart D Air Quality
§56/57.5002 - Exposure Monitoring
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Is the site conducting air quality monitoring for dust, gas, mist, and fumes miners encounter in the workplace?
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What possible contaminates does the site actively monitor
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Is sampling performed frequently enough to determine the adequacy of control measures
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Are exposure monitoring records well organized and available for review
§56/57.5005 - Exposure Controls
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Respiratory Protection Standard Z88.2-1969
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Does the site have an established respiratory protection program?
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Are all provided respirators NIOSH approved (42CFR Part 84)
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Does the site have a written respiratory protection program
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Does the program meet the minimum requirements of ANSI Z88.2-1969
§56/57.5037 - Radon Exposure Monitoring
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Is this an underground mine?
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Has the site conducted sampling to determine if radon daughters are present in exhaust air?
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When was this sampling last completed
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What was the Radon WL
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Was the Radon WL less than 0.1 WL
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Was the Radon WL less than 0.3WL
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Is the site completing Radon sampling at least every 3 months
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Is the site completing Radon sampling weekly?
§57.5040 - Radon Exposure Records
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Has the site found Radon exposure levels above 0.3 WL in active working areas
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Has the site completed exposure records for all employees working in areas with Radon exposure above 0.3WL
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Are records document on MSHA form 4000-9 "Record Of Individual Exposure To Radon Daughters"
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Has the site submitted MSHA form 4000-9 by February 15th of each calendar year
§57.5065 - Diesel Fuel Purchase Records
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Is this an underground mine
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Has the site retained purchase records for diesel fuel
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Do the purchase records show a sulfur content equal to or less than 0.05% (500ppm)
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Are records retained for at least one year from the date of purchase
§57.5066 - DPM Maintenance Standard
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Is this an underground mine
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Does the site retain a log of equipment taken out of service or requiring maintenance related to Diesel Particulate Matter emmissions
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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
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Has the site retained the information in the log for a minimum of one year after the equipment was examined
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Does the site have a list of authorized personnel who are qualified to maintain diesel equipment and their emissions components
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Are appropriate credentials or evidence of competence available for review
§57.5071 - DPM Exposure Monitoring
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Is this an underground mine
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Is the site conducting DPM sampling as necessary to determine the effectiveness of control
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Has the site posted notice of corrective actions for DPM over exposures on the bulletin board
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Has the site posted DPM sampling records on the bulletin board
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Are sample results posted within 15 days of receiving the results
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Are samples left posted for a minimum of 30 days
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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
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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
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Does the site have a procedure for controlling the blast site during loading and firing
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Does the site have a procedure for clearing and securing the blast area before initiation
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Does the site have a procedure for performing a post blast inspection and clearing the affected area
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Does the site have documentation (task training) for employees who are responsible for conducting a post blast examination
§56/57.6310 - Misfires
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Does the site have a procedure for evaluating and securing suspected blasting misfires
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Does the site have a procedure for eliminating an identified blasting misfire
§56/57.6502 - Safety Fuse
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Is safety fuse used for blasting initiation
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Is the burn rate of the fuse tested and posted for each new spool of fuse
27CFR 555.101
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Does the site have a valid and current permit to use explosives
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What is the current license number
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When does the current license expire
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Who is listed as the Responsible Person on the site explosives license
Part 57 - Subpart G Ventilation
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Is this an underground mine
§57.8520 - Ventilation Plan
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Does the site have a written ventilation plan containing the required information
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Mine Name (per Part 41 Legal ID)
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Mine maps of appropriate scale with all required information
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Fan data and specifications for all mane and booster fans
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Diagrams showing how ventilation is accomplished in each typical type of workplace
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A table of internal combustion engines with applicable information
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Is the written ventilation plan updated at least annually
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Date the current plan was issued
§57.8525 - Main Fan Maintenance Logs
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Does the site perform routine maintenance on the main ventilation fan(s)
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Does the site have a written maintenance schedule
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Are maintenance records retained and available for review
Part 56/57 - Subpart J Travelways & Escapeways
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Is this an Underground Mine
§57.11051 - Escape Routes
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Does the site conduct regular inspections of underground escape routes
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Are inspections documented
§57.11053 - Escape And Evacuation Plans
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Does the site have a documented escape and evacuation plan containing the required information
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Maps or diagrams displaying required information
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Procedures on how miners are notified during an emergency
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Evacuation instructions for each working area of the mine
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Firefighting plans/procedures
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Surface procedures for notification of authorities and the preparation of rescue equipment
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The location and availability of rescue personnel, rescue equipment, emergency power, etc.
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Assigned responsibilities of all key mine personal during an emergency
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Is the plan posted at areas of congregation and at shaft stations
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Is the plan updated with the most recent personnel, site, and evacuation information
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Date of most recent plan revision
§57.11058 - Check In / Check Out System
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Has the site established a system to check-in and check-out underground personnel
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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
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Does the site have a procedure for testing continuity and resistance of grounding systems
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Procedure for testing after installation
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Procedure for testing after repairs are made
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Procedure after system modifications
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Procedure for annual testing
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Does the site have a procedure for identifying portable tools and cords that have been tested annually
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Does the site have a record of all testing performed under this standard
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Record of the equipment tested
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Record of the type of test (installation, repair, modification, or annually)
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Record of the resistance measured
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Record of the date of the test
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Record of the person who conducted the test
Part 56/57 - Subpart L Compressed Air
§56/57.13015-Inspection Of Compressed Air Receivers
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Does the site have compressed air receiver tanks or pressure vessels
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Does the site have an updated list of all compressed air receivers and pressure vessels that are required to be inspected
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Does the site have records of inspection for all compressed air receivers and pressure vessels
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All all inspection records valid and completed before the expiration of the previous inspection record (if applicable)
§56/57.13017-Compressor Discharge Pipes
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Does the site have air compressors that may create carbon build up in the discharge pipes
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Is the discharge piping cleaned periodically per the manufacturer's recommendations or at least every two years
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Are cleaning records documented and available for review
§56/57.13030-Fired Pressure Vessels (Boilers)
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Does the site have fired pressure vessels (boilers)
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Does the site have an updated list of all boilers that are required to be inspected
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Does the site have records of inspection for all boilers
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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
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Does the site have a system for employees to perform pre-shift inspections of mobile equipment
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Does the site have a system for removing defective equipment from service
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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
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Has the site trained and designated competent persons to examine working places before work begins
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Does the site have a system to promptly notify miners in the affected area of adverse conditions identified during examination
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Does the site have a record of examination that contains the minimum required information (name, date, location, and adverse conditions found)
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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
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Are examination records maintained for a minimum of 1 year from the date of the examination
§56/57.18009-Designation Of Person in Charge
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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
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Is an individual capable of providing First Aid available on each working shift
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Does the site make First Aid training available to all interested miners
§56/57.18012-Emergency Telephone Numbers
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Does the site have a list of emergency contact numbers
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Is the list posted at appropriate locations (telephones, break rooms, etc.)
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Is the list updated to reflect current site staffing, emergency personnel, and outside response services
§56/57.18014-Emergency Medical Assistance & Transportation
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Has the site made advanced arrangements for receiving medical assistance and the transportation of injured miners
§56/57.18020-Working Alone
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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
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Does this mine use hoists for the transportation of personnel, supplies, or equipment?
§56/57.19001- Rated Capacities
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Does all hoisting equipment have a documented rated capacity?
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Are rated capacities consistent with the loads handled?
§56/57.19022-Rope Measurements
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Is the diameter of newly installed rope (post initial stretch) being measured?
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Are measurements taken in every third interval of active rope length and averaged?
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Are records of measurements certified by the person(s) completing the measurements?
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Are the records retained until the rope is retired from service?
§56/57.19120-Procedures For Inspection, Testing, And Maintenance
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Has a procedure for the inspection, testing, and maintenance of hoisting equipment been developed?
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Is the adopted procedure being followed?
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Does the procedure capture the necessary inspections and tests required to adequality maintain and ensure the safe functionality of the hoisting equpment?
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What deficiencies were observed?
§56/57.19121-Recordkeeping
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Are records of all inspections, tests, and maintenance kept and available for review?
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Are records certified by the person(s) performing the inspections, tests, and maintenance? (Name, Signature, Date)
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Are records retained for a minimum of one calendar year?
Part 56/57-Subpart S Miscellaneous
§56/57.20001-Intoxicating Beverages & Narcotics
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Does the site have a policy or program in place to prohibit the use of alcohol and drugs onsite
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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
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Does the site have any work produced or liberated dusts that are potentially explosive
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Have the dusts been tested for explosibility
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Date of the last test
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Did the tests identify a potential explosive hazard
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Have controls been put in place to mitigate potential hazards
Part 62-Hearing Conservation
§62.110(a)-Noise Exposure Assessment
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Has the site established a system to evaluate each miner's noise expsoure
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Is the miner's dose exposure made without adjustment for hearing protection
§62.110(d)-Miner Notification
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Does the site have a process of notifying the miner if their noise exposure exceeds the action level or PEL
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Does the notification include the required information (exposure determination and corrective actions)
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Are notifications provided within 15 days of the exposure determination
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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
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Are miners exposure to sound levels above the PEL enrolled in a Hearing Conservation Program
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Does the site use administrative controls to reduce miner's exposure to noise
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Are the identified administrative controls posted on the site's bulletin board
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Have the affected miners been provided copies of the administrative controls
§62.150-Hearing Conservation Program
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Does the site have a written Hearing Conservation Program (HCP)
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Does the HCP include the required sections
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System for monitoring miner's noise exposure
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The provision, training, and use of hearing protectors
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Audiometric testing
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Training
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Documentation and recordkeeping
§62.170-Audiometric Testing
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Does the site have a system in place to provide audiometric testing to miners enrolled in the HCP
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Are baseline audiograms completed within 6 months of HCP enrollment (or 12 months if mobile testing services are used)
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Are subsequent audiometric tests completed within 12 months of the baseline or the previous test
§62.174-Standard Threshold Shift Corrective Measures
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Has the site recorded any Standard Threshold Shifts (STS)
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Has the miner been retrained
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Has the miner been provided an opportunity to select different hearing protection
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Has the site reviewed and documented the effectiveness of engineering and administrative controls that may contribute to the STS
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Have all requirements been completed within 30 days of notification of the STS
§62.175-Notification Of Results & Reporting
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Has the site provided within 10 days notification of results regarding a follow up evaluation
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Does the notification include the required information (results and interpretation and reasons for further texting if applicable)
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Has the site reported to MSHA any incurred reportable hearing loss as required by Part 50
§62.180-Training
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Has the site provided HCP training to enrolled miners
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Was training provided within 30 days of enrollment
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Does the site provide re-training to miners at least every 12 months after the completion of their initial training
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Are training records documented to demonstrate compliance with this section
General Observations
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Are MSHA records and documents well organized
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General Comments
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Are MSHA records and documents easily accessible
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General Comments
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Does site staff know where to access MSHA documents and records
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General Comments
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Other Comments & Observations