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

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Appendix E

TUNNEL PREJOB SAFETY CONFERENCE CHECK LIST

This form outlines the subjects the Division will discuss at the Prejob Safety Conference.

1. PROJECT INFORMATION:
Starting date _____________________ Project Duration: ______________
a. Project Name ________________________________________________________________
Project Location________________________________________________________________
b. Name of Owner _______________________________________________________________
Owner's Address ________________________________________________________________
__________________________________________________ Phone ____________________
c. Contractor __________________________________________________________________
Contractor's Address ___________________________________________________________
________________________________________________________________________________
Employee's representative _______________________________ Phone _______________
________________________________________________________________________________

2. TUNNEL CLASSIFICATION:
Classification Type __________________________________ Date Issued ___________
Special Provisions _____________________________________________________________
General Geology ________________________________________________________________

3. TUNNEL SPECIFICATION:
a. Tunnel Diameter _________________________________ Tunnel Length __________
Shaft Diameter __________________________________ Shaft Depth ____________
b. Excavation Method and Support and Additional Details ________________________
____________________________________________________________________________
c. Jacking Pit: Length _______ Width __________ Depth _____ Soil Type___________
Pit Shoring Type/Slope ____________________________ Access/Egress ______________
Permit # and Competent Person ______________________________________________
Additional Details _________________________________________________________
____________________________________________________________________________

4. MANPOWER/TESTING EQUIPMENT
a. Total Manpower _____________ Max/shift UG ________ Statewide Employment ______
b. Supervisors ___________________________________________________________
c. Safety Rep. and No. ___________________________________________________
d. Gas Tester and No. ___________________________________________________________
e. Blaster and No. ______________________________________________________________
f. Gas Testing Equipment ________________________________________________________

5. EQUIPMENT
a. Mining Equipment _____________________________________________________________
Haulage _____________________________________________________________________
b. Cranes - Model/Capacity ______________________________________________________
c. Certification # _____________________ Date ____________
Crane and Rigging Inspection and Records ____________________________________
Hoisting Equipment __________________________________________________________
Cages and Work Platforms ____________________________________________________
Signals and Communication ___________________________________________________
d. Ventilation: Fan Model/HP/RPM ________________________________________________
Vent Line Size ________________ Length __________________ Material __________
Calculated CFM _________________________Reversible @surface? Yes ____ No_____
Auxiliary Fan_________________________________________________________________
e. Diesel Equipment: Diesel Permit Number ____________________________
List Other Equipment _____________________ ___________________ ______________
_________________ _____________________ ___________________ ______________
Scrubber Installation, inspection, and maintenance reviewed? _________________

6. REQUIRED POSTINGS:
a. Cal/OSHA_______ Emergency Plan ______ Telephone Nos. ______ Classification_____
b. Code of Safe Practices ______ Citations ________ Diesel and Other Permits _____

7. SANITATION AND FIRST AID:
First Aid Kit ___________ No. of Persons Trained in First-Aid _________ CPR_______

8. RELATED SAFETY ITEM DISCUSSION CHECKLIST:
a. State Mining and Tunnelling Program, including Inspections, procedures, citations,
training, and technical assistance.
b. Reporting accidents and incidents to DOSH in 24 hours.
c. Gas tests, calibration, records, frequency, notifying DOSH.
d. Required Occupational Injury and Illness record keeping.
e. Crane boom clearance, with overhead high voltage power lines, and set-up. Daily and
other inspections, including quarterly.
f. Required Inspections, assignment, schedule, records.
g. Identification and location(s) of existing utilities.
h. Fire prevention, protection, and special provisions.
i. Hazardous material training and information.
j. Hearing Conservation Program requirements.
k. Dust Control, Sampling, Respiratory Protection Program elements.
l. Personal protective equipment: hard hats, steel-toe boots, self rescuers, welding goggles
and clothing, safety belts, and lines.
m. Traffic control, protection, warnings, reflective vests, etc.
n. Tunnel and shaft lighting, emergency and personnel lighting in case of power failure, and
laser safety if laser is used.
o. Tunnel communication system and underground utility lines.
p. Explosives-type, system, storage, transport, warning system.
q. Safety Meetings: Monthly ________ Weekly _____________ Records __________
r. Check-in system, primary and secondary exit protection/provision.
s. Underground Rescue Plan: Yes _____ No ________ Reviewed? Yes _______ No________
If IIPP is reviewed, attach Check List.
t. Employee and supervisory training requirements and programs.

9. NOTES AND DETAILS:

______________________________________________________________________________________

10. SKETCH (IDENTIFY):

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

Appendix E

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