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Subchapter 20. Tunnel Safety Orders
Article 24. Licensing of Blasters

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Appendix D

Weekly Shaft Inspection Report To Be Filed In The Tunnel Office

Name of Inspector_______________________________
Date____________________________________________

Remarks

Fire fighting equipment_______________________________________________
Timber ground support, loose material ________________________________
Guides or track_______________________________________________________
Shaft rope, idlers or deflection sheaves______________________________
Safety gates or guard rails __________________________________________
Safety hood on cages or skips ________________________________________
Daily inspection and maintenance of safety dogs ______________________
	On cage or skip________________________________________
	Sunday ________________________________________________
	Monday ________________________________________________
	Tuesday _______________________________________________
	Wednesday _____________________________________________
	Thursday ______________________________________________
	Friday ________________________________________________
	Saturday ______________________________________________
Skip or cage coupling____________________________________________________
Top sheave wheel ________________________________________________________
Overwinding devices limit switches, safeties and governors_______________
_________________________________________________________________________
Shaft clearance _________________________________________________________
Chutes __________________________________________________________________
Chute gates _____________________________________________________________
Bell signal system ______________________________________________________
Telephone system ________________________________________________________
Manway __________________________________________________________________
Laddders and platforms __________________________________________________
Date hoisting rope was last cut off _____________________________________
Length of hoisting rope removed _________________________________________
Hoisting rope (see Tunnel Safety Order, Section 8497) ___________________
_________________________________________________________________________


NOTE: Authority cited: Sections 142.3 and 7997, Labor Code. Reference: Sections 142.3 and 7997, Labor Code.

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