MINE EMERGENCY RESPONSE CHECKLIST

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--- INCIDENT NOTIFICATION & ACTIVATION ---
[ ] Time of Incident Notification
[ ] Notification Method (e.g., Radio, Phone, Alarms) (Radio, Phone, Alarm System, Other)
[ ] Number of People Initially Notified
[ ] Brief Description of Incident Triggering Notification
[ ] Emergency Level (e.g., Minor, Moderate, Severe) (Minor, Moderate, Severe)
[ ] Approximate Incident Location
[ ] Date of Incident Notification

--- EMERGENCY ASSEMBLY POINTS & HEADCOUNT ---
[ ] Primary Assembly Point Location
[ ] Expected Personnel at Primary Assembly Point
[ ] Actual Personnel Present at Primary Assembly Point
[ ] Roll Call Status (Complete, Partial, Incomplete)
[ ] Notes on Roll Call / Missing Personnel
[ ] Roll Call Completion Date
[ ] Roll Call Completion Time
[ ] Secondary Assembly Point Required? (Yes, No)

--- COMMUNICATION & COORDINATION ---
[ ] Communication Method Used (Initial) (Radio, Phone, Alarm System, PA System)
[ ] Radio Channel Used
[ ] Emergency Services Notified? (Yes, No)
[ ] Emergency Services Contact Information
[ ] Time of Initial Contact with Emergency Services
[ ] Personnel Notified (Select All That Apply) (Mine Manager, Safety Officer, First Aid Team, Contractors)
[ ] Message Clarity Assessment (1-5, 5 being Clear)

--- FIRST AID & MEDICAL RESPONSE ---
[ ] Number of Trained First Aiders Present
[ ] First Aid Kits Location Verified? (Yes, No, N/A)
[ ] Oxygen Supply Available & Verified? (Yes, No, N/A)
[ ] Last First Aid Kit Expiry Date Checked?
[ ] Estimated Time for Medical Assistance to Arrive
[ ] Notes on Any Existing Medical Conditions of Personnel (if known)
[ ] Attach First Aid Training Records (if applicable)

--- RESCUE OPERATIONS READINESS ---
[ ] Number of Trained Rescue Personnel
[ ] Rescue Team Activation Status (Ready, Standby, Unavailable)
[ ] Last Rescue Team Training Date
[ ] Estimated Rescue Response Time
[ ] Rescue Equipment Inspection Report
[ ] Available Rescue Equipment (Self-Contained Breathing Apparatus (SCBA), Rope Rescue Gear, Search and Rescue Dogs, Emergency Medical Supplies, Specialized Rescue Vehicles)
[ ] Location of Primary Rescue Equipment Cache

--- MINE VENTILATION & AIR QUALITY ---
[ ] Ventilation Fan RPM
[ ] Airflow (mÂ³/s or CFM)
[ ] Oxygen Level (%)
[ ] Carbon Monoxide (CO) Level (ppm)
[ ] Methane (CH4) Level (ppm)
[ ] Ventilation System Status (Normal, Reduced, Alarm, Offline)
[ ] Time of Ventilation Monitoring

--- FIRE SUPPRESSION SYSTEMS ---
[ ] Water Tank Level (%),
[ ] Fire Hose Pressure (PSI) â€“ Check & Record: (Nominal, Low, High)
[ ] Last Fire Suppression System Inspection Date:
[ ] Time of Fire Suppression System Inspection:
[ ] Fire Extinguishers - Status (Select all that apply): (Charged, Partially Discharged, Discharged, Needs Inspection, Not Available)
[ ] Sprinkler System Functional Test Result: (Passed, Failed, Not Tested)

--- HAZARDOUS MATERIALS HANDLING ---
[ ] Type of Hazardous Material Involved (if applicable) (Explosives, Flammable Liquids, Toxic Gases, Corrosives, Radioactive Materials, Other - Specify in Long Text)
[ ] Detailed Description of Released Material (if 'Other' selected)
[ ] Estimated Volume/Quantity Released (in appropriate units)
[ ] Containment Measures Implemented (e.g., booms, absorbent materials)
[ ] Personal Protective Equipment (PPE) Used (Respirator, Gloves, Eye Protection, Protective Clothing, Boots)
[ ] Spill/Release Location (GPS Coordinates)
[ ] Date of Spill/Release
[ ] Time of Spill/Release

--- POST-INCIDENT DEBRIEFING & REPORTING ---
[ ] Incident Date
[ ] Incident Time
[ ] Detailed Incident Narrative
[ ] Severity Level (Minor, Moderate, Major, Critical)
[ ] Estimated Cost of Damage
[ ] Lessons Learned & Recommendations
[ ] Supporting Documentation (Photos, Reports)
[ ] Reporting Status (Draft, Submitted, Approved)

--- EQUIPMENT & RESOURCE AVAILABILITY ---
[ ] Number of Fully Charged Emergency Lighting Units
[ ] Number of Supplied Air Respirators (SARs) Available
[ ] Availability of First Aid Kits (Specify Locations) (Surface First Aid Station, Underground First Aid Station 1, Underground First Aid Station 2)
[ ] Condition of Communication Radios (All Units) (Functional, Requires Maintenance, Non-Functional)
[ ] Amount of Available Oxygen Cylinders (Full)
[ ] Condition of Escapeways (Clear of Obstructions) (Clear, Minor Obstruction, Significant Obstruction)

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