PLANNED TASK OBSERVATION REPORT

JOB FACE PREPARATION

LOCATION

TRAINING
ASSESSOR

OPERATOR SAFETY AND OBSERVATION

SI NO ITEMS TO CHECK

1 Was a brief Risk Assessment carried out.

2 Ensure proper use of PPE. Goggles & Gloves, self-rescuer,

overall clean, footwear etc.

3 Wash roof, sidewalls and face up to the wiremesh and eliminate

dust in the rock surface.

4 Check the back – sidewalls and face for any loose and scale
down.

5 Clean area of all loose up to wiremesh to prevent slipping and

falling .
6 Work carried out safely
7 Area checked for misfires
8
C/L and G/L clearly and accurately marked on roof and sidewalls
9 Is design plan available.
10 Side wall offsets measured accurately from center line
11 socket clearly marked
12 Previous cut clearly marked
13 Grid lines marked accurately and in line with design
14 Floor clean at face to insure lifters can be drilled as per design
15 All materials removed from face and housekeeping in order
16 Was work carried out as per SOP
REASON FOR OBSERVATION - 1) Accident follow -up 2) Training follow- up 3) Ha
experienced worker check 5) others
 SI NO TASK OBSERVATIONS
Could any of the practices or conditions observed result in
property damage or personal injury?
1

2 Did the practices you observed comply with all of the

applicable standards that exist for this task ?

3 Were the methods and practices observed the most efficient

and productive ?

4 Have you properly complemented and /or reinstructed the

worker on these observations ?

5 Describe any follow -up actions I.e, Procedure , Method or Equipment you observed
consider changing in the interest of SAFETY, QUALITY, ENVIRONMENT O

Signatur : ----------------- (supervisor / observer ) Signature : ----------------- ( opera

ERVATION REPORT

PREPARATION

DATE

NAME OF PERFORMER

ND OBSERVATION

COMPLIED NON - COMPLIANCE

2) Training follow- up 3) Hazardous Task 4)

 YES NO

Method or Equipment you observed that Managemnt should

ETY, QUALITY, ENVIRONMENT OR PROPERTY.

Signature : ----------------- ( operator )