Remote Mucking Task Observation*

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

OBSERVATIONS

• Is the wedge installed as per standard?

  Yes

  No

• Is the remote mucking bay/wedge clean and free of obstructions?

  Yes

  No

• Does the operator retreat into the mucking bay/wedge when scoop is within 25 feet? (Is the operator in a safe position should he lose control of the scoop?)

  Yes

  No

• Has the commissioning form been completed and reviewed?

  Yes

  No

• Are the proper signs posted?

  Yes

  No

• Is the operator familiar with the policy and procedures for this task?

  Yes

  No

• Is the operator trained on this particular piece of equipment?

  Yes

  No

• Does the operator have good line-of-site while mucking from the wedge?

  Yes

  No

• Does the operator have trouble with start up?

  Yes

  No

• Does the scoop hit the walls during remote mucking operation?

  Yes

  No

• Is it difficult to retrieve a bucket of muck?

  Yes

  No

• Does the operator stop the scoop at a safe distance from the wedge?

  Yes

  No

  N/A

• Does the operator place the scoop at a safe distance from the open brow?

  Yes

  No

• Has the operator demonstrated the proper steps in the operation of remote mucking?

  Yes

  No

• Observers comments:

OPERATOR QUESTIONS:

• Are you familiar with the policies and procedures for the remote mucking operation?

  Yes

  No

• Are you trained and do you have the knowledge to do this task?

  Yes

  No

• Are you comfortable with the remote mucking set up?

  Yes

  No

• How can we improve this workplace?

• Other comments?

• Workers Name and Payroll #:

• Media (if needed)

  Media

• Observers Signature:

  Sign