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Mine Emergency Response Checklist

Ensure rapid, effective response during critical mine emergencies. This checklist guides thorough preparedness, equipment checks, and evacuation procedures, minimizing risks and safeguarding personnel. Stay compliant and ready for anything.

This Template was installed 5 times.

Incident Notification & Activation

1 of 10

Steps to initiate the emergency response and notify relevant personnel.

Time of Incident Notification

Notification Method (e.g., Radio, Phone, Alarms)

Number of People Initially Notified

Brief Description of Incident Triggering Notification

Emergency Level (e.g., Minor, Moderate, Severe)

Approximate Incident Location

Date of Incident Notification

Emergency Assembly Points & Headcount

2 of 10

Procedures for directing personnel to safe assembly areas and confirming their presence.

Primary Assembly Point Location

Expected Personnel at Primary Assembly Point

Actual Personnel Present at Primary Assembly Point

Roll Call Status

Notes on Roll Call / Missing Personnel

Roll Call Completion Date

Roll Call Completion Time

Secondary Assembly Point Required?

Communication & Coordination

3 of 10

Verification of communication systems and coordination with emergency services.

Communication Method Used (Initial)

Radio Channel Used

Emergency Services Notified?

Emergency Services Contact Information

Time of Initial Contact with Emergency Services

Personnel Notified (Select All That Apply)

Message Clarity Assessment (1-5, 5 being Clear)

First Aid & Medical Response

4 of 10

Assessment of first aid resources and medical response protocols.

Number of Trained First Aiders Present

First Aid Kits Location Verified?

Oxygen Supply Available & Verified?

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

5 of 10

Checklist for rescue equipment and team preparedness.

Number of Trained Rescue Personnel

Rescue Team Activation Status

Last Rescue Team Training Date

Estimated Rescue Response Time

Rescue Equipment Inspection Report

Available Rescue Equipment

Location of Primary Rescue Equipment Cache

Mine Ventilation & Air Quality

6 of 10

Confirmation of ventilation systems and air quality monitoring.

Ventilation Fan RPM

Airflow (m³/s or CFM)

Oxygen Level (%)

Carbon Monoxide (CO) Level (ppm)

Methane (CH4) Level (ppm)

Ventilation System Status

Time of Ventilation Monitoring

Fire Suppression Systems

7 of 10

Inspection and verification of fire suppression equipment functionality.

Water Tank Level (%),

Fire Hose Pressure (PSI) – Check & Record:

Last Fire Suppression System Inspection Date:

Time of Fire Suppression System Inspection:

Fire Extinguishers - Status (Select all that apply):

Sprinkler System Functional Test Result:

Hazardous Materials Handling

8 of 10

Procedures for handling and containing hazardous materials released during an emergency.

Type of Hazardous Material Involved (if applicable)

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

Spill/Release Location (GPS Coordinates)

Date of Spill/Release

Time of Spill/Release

Post-Incident Debriefing & Reporting

9 of 10

Steps for conducting a debriefing and submitting necessary reports after the emergency.

Incident Date

Incident Time

Detailed Incident Narrative

Severity Level

Estimated Cost of Damage

Lessons Learned & Recommendations

Supporting Documentation (Photos, Reports)

Reporting Status

Equipment & Resource Availability

10 of 10

Confirmation of necessary equipment (e.g., lighting, PPE) and resources are readily available.

Number of Fully Charged Emergency Lighting Units

Number of Supplied Air Respirators (SARs) Available

Availability of First Aid Kits (Specify Locations)

Condition of Communication Radios (All Units)

Amount of Available Oxygen Cylinders (Full)

Condition of Escapeways (Clear of Obstructions)

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