Weekly Refuge Station Inspection

• Location
  Address

• Prepared by

• Conducted on

  Date

• Other personnel attending the inspection

Access

• Proper signs posted and clearly identified "REFUGE STATION"?

  Yes

  No

  N/A

• Is access clearly illuminated?

  Yes

  No

  N/A

Fire Extinguishers

• Are fire extinguishers available and accessible?

  Yes

  No

  N/A

• Do the fire extinguishers have their monthly compliance stamp?

  Yes

  No

  N/A

Housekeeping

• Is approach to Refuge Station free of garbage and debris?

  Yes

  No

  N/A

• Is the air lock clean and orderly at the time of inspection?

  Yes

  No

  N/A

Safety Equipment

• General condition of the stretcher and accessories

  Safe

  At Risk

  N/A

• Is the first aid kit sealed?

  Yes

  No

  N/A

• Is adequate door sealant available? (Required only in C9290 refuge)

  Yes

  No

  N/A

• Independent air supply (oxygen generator)

  Safe

  At Risk

  N/A

• Emergency water and food supply

  Safe

  At Risk

  N/A

• Temperature control equipment

  Safe

  At Risk

  N/A

• Is the gas testing equipment functioning correctly?

  Yes

  No

  N/A

Communications

• Are sign off sheets in case of emergency available

  Yes

  No

  N/A

• Is the telephone working?

  Yes

  No

  N/A

• Is the radio working?

  Yes

  No

  N/A

• Is the PED working?

  Yes

  No

  N/A

• Is the Code of Conduct for Persons Occupying the Refuge Station posted inside?

  Yes

  No

  N/A

• Is there an up to date copy of the Mine Ventilation Plan and escape routes posted?

  Yes

  No

  N/A

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