A
Vulcan Construction Materials, LP EMS DAILY OPERATOR'S REPORT-- MOBILE EQUIPMENT
Plant Name / ID Operator Name Equipment # Scheduled Hrs
C
1 - HUMAN SAFETY 2 - ENVIRONMENTAL PROTECTION 3- PROPERTY PROTECTION 4 - PRODUCTION
THERE IS NO JOB SO IMPORTANT NO SERVICE SO NEEDED THAT WE CAN NOT TAKE THE TIME TO DO THE JOB SAFELY Employee completes a Work Place Inspection for all locations:
Code X = Needs Correction (List Defect in Comments Section) √ = OK - No Defect Found e 1. ENTRANCES & TRAVELWAYS LOCATION LOCATION ye plo 2. WORK AREA/HEADING 1 2 3 Em Blasting/Shunts/Signs/Lines Road Conditions Initial = Correction Made LOCATION
4 5 6
OPERATING HOURS Hour Meter
End Begin Operating Delay
NON-PRODUCTIVE HOURS (see back for code)
Hours Code Idle Hours
Odometer
End Begin Operating Down Off-Shift
Ground Control/Back/Ribs/Wire/Scaling Scaling Bar Present Ventilation/Vent line/Bag/Fans
WORKING HOURS
Primary Stripping Stockpiling Loads Hours Diesel Gasoline Engine Hydraulic other--description
FUEL / LUBES (gallons)
Gear Trans
Dust Suppression/Muck Piles/Spray Bars Signs/Barricades/Guards Sumps/Pumps/Water Level Training/Task/Other Escapeway/Access/Ladders/Signs P.P.E. Brass/cap lamp/self rescuer/etc present & used Fall Protection Devices Ropes/Slings 3 Point Contact Tools/Personal/Company Provided Fire Suppres./Exting.
DATES:
LIST DEFECTS OR OTHER COMMENTS (more room on back)
Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location OXY-Acetylene Cylinders stored properly Loockout/Tagout/Tryout HAZMAT Storage/Labeling Mobile Equip. Procedures Flammable Cabinet/Condition/Contents Flammables/Combustibles stored properly Lighting & Illumination Blue Room Condition/Location Other
3. ARE PERSONNEL WORKING PROPERLY? (CHECK BOX)
(OBSERVATION POSITIVE & NEGATIVE)
YES
NO
COMMENTS:
4. COACHING OPPORTUNITY
COMMENTS:
so r Su pe r vi
(INTERACTION W/EMPLOYEE USE OBSERVATION POSITIVE & NEGATIVE FOR TOPIC)
Operators Signature:
Supervisors Signature:
5. CAN WE CONTINUE TO WORK SAFELY?
(AGREEMENT W/EMPLOYEE & SUPERVISOR)
YES
NO
COMMENTS:
B
1 - HUMAN SAFETY
VULCAN WORK PLACE INSPECTION
2 - ENVIRONMENTAL PROTECTION 3- PROPERTY PROTECTION 4 - PRODUCTION
THERE IS NO JOB SO IMPORTANT NO SERVICE SO NEEDED THAT WE CAN NOT TAKE THE TIME TO DO THE JOB SAFELY Employee completes a Work Place Inspection for all locations: Plant:__________ Date:________ Shift: 1 2 _____ Pit/Quarry/Highwall _____ Primary Crusher _____ Stockpile/Loadout/Shipping _____ Processing Plant/Crusher _____ Drill/Blast _____ Other _____ Shop/Yard
plo Em ye e
Employee Signature: NEAR MISS: (describe)
Supervisors Signature:
Privileged Document 3
1. ENTRANCES & TRAVELWAYS
2. WORK AREA/HEADING
Blasting/Shunts/Signs/Lines Scaling Bar Present Ventilation/Vent line/Bag/Fans Dust Suppression/Muck Piles/Spray Bars Signs/Barricades/Guards Sumps/Pumps/Water Level Escapeway/Access/Ladders/Signs Fire Suppres./Exting.
DATES:
Road Conditions Signs/Barricades/Guards Sumps/Pumps/Water Level Escapeway/Access/Ladders/Housekeeping/Signs Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location Shop floors/areas Training/Task/Other Escapeway/Access/Ladders/Houskeeping/Signs P.P.E. Present & Used Fall Protection Devices Ropes/Slings 3 Point Contact Tools/Personal/Company Provided Other
Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location OXY-Acetylene Cylinders stored properly Loockout/Tagout/Tryout HAZMAT Storage/Labeling Mobile Equip. Procedures Flammable Cabinet/Condition/Contents Flammables/Combustibles stored properly Lighting & Illumination Blue Room Condition/Location Other
I HAVE INSPECTED MY WORK AREAS & THEY ARE SAFE TO WORK IN. I HAVE NOT BEEN INVOLVED IN AN ACCIDENT, INCIDENT, OR INJURY WHILE AT WORK TODAY.
□ YES
30 CFR 56/57.18002 (a)
□ NO
Employee Signature:
PRE-OPERATION MOBILE INSPECTION
Note defects. DO NOT OPERATE IF SAFETY IS COMPROMISED
Equipment # Date System 1. Windshield / windows 2. Windshield Wipers 3. Mirrors (incl spots) 4. Horn 5. Backup Alarm 6. Strobe 7. Ladder, Stairs, Rails 8. Service Brakes 9. Parking Brakes 10. Retarded 11. Seat Belt & Tethers 12. Fire Extinguisher 13. Housekeeping 14. ROPS and/or FOPS 15. Steering Control 16. Aux. Steering 17. Tires, Wheels, Lugs 18. Driving Lights 19. Brake lights 20. Other Lights 21. Oil Pressure Gauge 22. Water Temp Gauge 23. Torque Conv Temp. 24. Clutch Pressure 25. Air Pressure 26. Amp or Volt Meter 27. Heater/Air conditioner 28. Door & Window Seals 29. Insulation & Floor Mat 30. Two-way Radio 31. Tach and/or Speed 32. Fuel gauge 33. _________________ 34. _________________
Description Time Pre-Op
OK INOP N/A Date Repaired / Initial
Turn in at the start of the shift
I have inspected this equipment and found it to be safe to operate: Operator signature
ON-SHIFT MOBILE INSPECTION
Note conditions that develop during the shift and turn in at the end of the shift
EMS DAILY OPERATOR'S REPORT-- MOBILE EQUIPMENT
Plant Name / ID Equipment # Scheduled Hrs
Equipment # Date System
Description Time Pre Op
OK INOP N/A OK
Turn in at the end of the shift
On-Shift
INOP N/A Date Repaired / Initial
Operator Name
OPERATING HOURS
NON-PRODUCTIVE HOURS (see back for code)
1. Windshield / windows 2. Windshield Wipers 3. Mirrors (incl spots) 4. Horn 5. Backup Alarm 6. Strobe 7. Ladder, Stairs, Rails 8. Service Brakes 9. Parking Brakes 10. Retarder 11. Seat Belt & Tethers 12. Fire Extinguisher 13. Housekeeping 14. ROPS and/or FOPS 15. Steering Control 16. Aux. Steering 17. Tires, Wheels, Lugs 18. Driving Lights 19. Brake lights 20. Other Lights 21. Oil Pressure Gauge 22. Water Temp Gauge 23. Torque Cov Temp. 24. Clutch Pressure 25. Air Pressure 26. Amp or Volt Meter 27. Heater/Air conditioner 28. Door & Window Seals 29. Insulation & Floor Mat 30. Two-way Radio 31. Teach and/or Speed 32. Fuel gauge 33. _________________ 34. _________________
Hour Meter
End Begin Operating Delay
Hours
Code Idle
Hours
Code
Odometer
End Begin Operating Down Off-Shift
WORKING HOURS
Primary Stripping Stockpiling Loads Hours Diesel Gasoline Engine Hydraulic other--description
FUEL / LUBES (gallons)
Gear Trans
LIST DEFECTS OR OTHER COMMENTS (more room on back)
Operators Signature:
pre-op signature
Supervisors Signature:
CODES Delay
Fuel, Lube & Inspections Warm-up Equipment Crusher Hang-up / Chute Meetings / Lunch Metal Detector Out of Rock Plant Automation Other Equipment Weather Waiting on Shot
A
1 - HUMAN SAFETY
WORK PLACE INSPECTION
2 - ENVIRONMENTAL PROTECTION 3- PROPERTY PROTECTION 4 - PRODUCTION
Idle 201 202 203 204 205 206 206 208 209 210
Standby Crusher Hang-up / Chute Inspection & Service Meeting / Lunch No Operator Other Equipment Out of Plan Out of Rock Plant Automation Wait for Shot Weather
601 THERE IS NO JOB SO IMPORTANT NO SERVICE SO NEEDED 602 THAT WE CAN NOT TAKE THE TIME 603 TO DO THE JOB SAFELY 604 605 606 Employee completes a Work Place Inspection for all locations: 607 Plant:__________ Date:________ Shift: 1 2 608 _____ Pit/Quarry/Highwall _____ Primary Crusher 609 _____ Stockpile/Loadout/Shipping _____ Processing Plant/Crusher 610 _____ Drill/Blast _____ Other 611 _____ Shop/Yard
ee loy mp E
3
Down
Mechanical Breakdown Preventative Maintenance Air Conditioning / Heating Attachments Bearings Brakes Driveline / U-Joints Electrical Engine / Motor Hydraulic Hose Hydraulic Cylinder / Pump Planetary / Differential Tires / Tracks Transmission
1. ENTRANCES & TRAVELWAYS
2. WORK AREA/HEADING
Blasting/Shunts/Signs/Lines Scaling Bar Present Ventilation/Vent line/Bag/Fans Dust Suppression/Muck Piles/Spray Bars Signs/Barricades/Guards Sumps/Pumps/Water Level Escapeway/Access/Ladders/Signs Fire Suppres./Exting.
DATES:
401 402 403 404 405 406 406 408 409 410 411 412 413 414
Off-Shift
Mechanical Breakdown Preventative Maintenance Air Conditioning / Heating Attachments Bearings Brakes Driveline / U-Joints Electrical Engine / Motor Hydraulic Hose Hydraulic Cylinder / Pump Planetary / Differential Tires / Tracks Transmission
801 802 803 804 805 806 807 808 809 810 811 812 813 814
Road Conditions Signs/Barricades/Guards Sumps/Pumps/Water Level Escapeway/Access/Ladders/Housekeeping/Signs Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location Shop floors/areas Training/Task/Other Escapeway/Access/Ladders/Houskeeping/Signs P.P.E. Present & Used Fall Protection Devices Ropes/Slings 3 Point Contact Tools/Personal/Company Provided Other
Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location OXY-Acetylene Cylinders stored properly Loockout/Tagout/Tryout HAZMAT Storage/Labeling Mobile Equip. Procedures Flammable Cabinet/Condition/Contents Flammables/Combustibles stored properly Lighting & Illumination Blue Room Condition/Location Other
Do not operate if identified equipment defects affect safety of operation. Examples include, but are not limited to: inadequate parking brakes and service brakes; defects in steering; conditions that may cause engine failure or loss of hydraulic or air pressure; warning system defects (horn, back-up alarm, system malfunction alarms, brake lights); discharged or defective fire extinguisher; frayed seat-belt or tether, any condition that inhibits normal visibility; defective or missing handrails, grab rails, ladder rungs or stair steps. Minor conditions that could be scheduled for repair include: minor oil drips; window cracks that do not affect visibility; non-critical wear items; ventilation system defects; non-critical instrumentation malfunction; eraly stages of seatbelt wear; unusual noises; worn door seals, floor mats; etc.
I HAVE INSPECTED MY WORK AREAS & THEY ARE SAFE TO WORK IN.
30 CFR 56/57.18002 (a)
Employee Signature:
B
1 - HUMAN SAFETY
WORK PLACE INSPECTION
2 - ENVIRONMENTAL PROTECTION 3- PROPERTY PROTECTION 4 - PRODUCTION
THERE IS NO JOB SO IMPORTANT NO SERVICE SO NEEDED THAT WE CAN NOT TAKE THE TIME TO DO THE JOB SAFELY Employee completes a Work Place Inspection for all locations:
X = Needs Correction (List Defect in Comments Section) √ = OK - No Defect Found e 1. ENTRANCES & TRAVELWAYS LOCATION LOCATION ye plo 2. WORK AREA/HEADING 1 2 3 Em Blasting/Shunts/Signs/Lines Road Conditions Ground Control/Back/Ribs/Wire/Scaling Scaling Bar Present Ventilation/Vent line/Bag/Fans Dust Suppression/Muck Piles/Spray Bars Signs/Barricades/Guards Sumps/Pumps/Water Level Training/Task/Other Escapeway/Access/Ladders/Signs P.P.E. Brass/cap lamp/self rescuer/etc present & used Fall Protection Devices Ropes/Slings 3 Point Contact Tools/Personal/Company Provided Fire Suppres./Exting.
DATES:
Initial = Correction Made LOCATION
4 5 6
Housekeeping/Trash/Rags/Belt Spillage Garbage Cans/Trash/Lids/Condition/Location OXY-Acetylene Cylinders stored properly Loockout/Tagout/Tryout HAZMAT Storage/Labeling Mobile Equip. Procedures Flammable Cabinet/Condition/Contents Flammables/Combustibles stored properly Lighting & Illumination Blue Room Condition/Location Other
3. ARE PERSONNEL WORKING PROPERLY? (CHECK BOX)
(OBSERVATION POSITIVE & NEGATIVE)
YES
NO
COMMENTS:
Su pe rv is or
4. COACHING OPPORTUNITY
(INTERACTION W/EMPLOYEE USE OBSERVATION POSITIVE & NEGATIVE FOR TOPIC)
COMMENTS:
5. CAN WE CONTINUE TO WORK SAFELY?
(AGREEMENT W/EMPLOYEE & SUPERVISOR)
YES
NO
COMMENTS:
Employee Signature: NEAR MISS: (describe)
Supervisors Signature: