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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) ___________________ _________________________________________________________________________
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