Three Oaks Mine

• Document No.1

• Safety Audit

• Conducted on

  Date

• Prepared by

• Location
  Address

Parts Trailer

• Stairs in good shape

  Yes

  No

  N/A

• Adequate lighting

  Yes

  No

  N/A

• Clear walkway

  Yes

  No

  N/A

• Fire extinguishers good/inspected.

  Yes

  No

  N/A

Yard/walkways

• Bladed down

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

Flamables cabinets

• Fire extinguusher

  Yes

  No

  N/A

• Proper storage

  Yes

  No

  N/A

• Labeled correctly

  Yes

  No

  N/A

Fueling areas

• Berms good?

  Yes

  No

  N/A

• Fire extinguisers

  Yes

  No

  N/A

• Clear of grass and weeds

  Yes

  No

  N/A

• Free of flammable materials

  Yes

  No

  N/A

• Proper labels

  Yes

  No

  N/A

Lube trailer

• Free of trash

  Yes

  No

  N/A

• Wheels chocked

  Yes

  No

  N/A

• Labels good

  Yes

  No

  N/A

• Fire extinguishers

  Yes

  No

  N/A

• Ladder in good condition?

  Yes

  No

  N/A

Port a potties

• Clean

  Yes

  No

  N/A

• Enough

  Yes

  No

  N/A

• Paper

  Yes

  No

  N/A

Parking area

• Clean

  Yes

  No

  N/A

• Bladed down

  Yes

  No

  N/A

Far fuel station

• Fire extinguishers

  Yes

  No

  N/A

• Free of weeds and grass

  Yes

  No

  N/A

• Labeled properly

  Yes

  No

  N/A

• No trash

  Yes

  No

  N/A

Berms

• Sufficient height

  Yes

  No

  N/A

• Grade/slope good

  Yes

  No

  N/A

• Enough where needed

  Yes

  No

  N/A

Pressure washer

• Labeled water tank

  Yes

  No

  N/A

• Face shield used

  Yes

  No

  N/A

• Wheels chocked

  Yes

  No

  N/A

• Area clean

  Yes

  No

  N/A

Signage

• Easy to follow

  Yes

  No

  N/A

Equipment

• Check preoperative checklist

  Yes

  No

  N/A

• Did operator list all discrepancies?

  Yes

  No

  N/A

• Has supervised put in work order?

  Yes

  No

  N/A

Personnel

• Hydrated

  Yes

  No

  N/A

• Alert

  Yes

  No

  N/A

• Can operator list one of the rules to live by

  Yes

  No

  N/A

• Can operator tell me where msds is?

  Yes

  No

  N/A

Equipment 2

• Preop done

  Yes

  No

  N/A

• All discrepancies listed

  Yes

  No

  N/A

• Has supervisor put work order in if needed

  Yes

  No

  N/A

Personnel 2

• Hydrated

  Yes

  No

  N/A

• Alert

  Yes

  No

  N/A

• Does operator know two rules to live by

  Yes

  No

  N/A

• Where is msds

  Yes

  No

  N/A