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Pre-shift and on-shift workplace examination per 30 CFR Part 56/57
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Examination Items
Mark the applicable column for each item: OK = Satisfactory | Fail = Not met | N/A = Not applicable. Record notes for any Fail.
| # | Examination Item | OK | Fail | N/A | Notes / Action |
|---|---|---|---|---|---|
| Ground Conditions | |||||
| 1 | Ground stability assessed, no signs of slumping or cracks | ||||
| 2 | Roof and ribs scaled and supported as required | ||||
| 3 | Rock bolts, mesh and ground support intact | ||||
| Ventilation | |||||
| 4 | Adequate airflow confirmed at working faces | ||||
| 5 | Ventilation controls (stoppings, curtains) in place and intact | ||||
| 6 | Methane and gas readings within permissible limits | ||||
| Electrical | |||||
| 7 | Trailing cables free from damage and properly spliced | ||||
| 8 | Electrical panels and switchgear covers secured | ||||
| 9 | Ground fault protection devices tested and functional | ||||
| Equipment Guards | |||||
| 10 | All rotating parts guarded and guards secure | ||||
| 11 | Conveyor belt guards, nip points and pull cords in place | ||||
| 12 | Crusher and mill guarding intact and access gates locked | ||||
| 13 | Emergency stop devices accessible and operational | ||||
| # | Examination Item | OK | Fail | N/A | Notes / Action |
|---|---|---|---|---|---|
| Housekeeping | |||||
| 14 | Walkways and travelways clear of obstructions | ||||
| 15 | Materials stored safely and not blocking exits | ||||
| 16 | Spillage and accumulation of combustible materials cleared | ||||
| 17 | Drainage adequate, no standing water in work areas | ||||
| Emergency Facilities | |||||
| 18 | Fire extinguishers present, tagged and accessible | ||||
| 19 | Self-contained self-rescuers (SCSRs) available and in date | ||||
| 20 | Escape routes clearly marked and unobstructed | ||||
| 21 | First aid supplies stocked and accessible | ||||
| 22 | Communication systems (phones, radios) operational | ||||
Declaration
I confirm that all examination items have been inspected as indicated above. Any hazardous conditions identified have been recorded, reported and either corrected or danger-tagged. This examination has been conducted in accordance with MSHA 30 CFR Part 56/57 requirements.