196 - AL-F01 | Scaffold Hold, Release & Mine Handover Record
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UNDER GRD MINE — ORIGINAL EDITABLE WORD | R12.95
AL-F01 — SCAFFOLD HOLD, RELEASE & MINE HANDOVER RECORD
The five-stage hold/release Word form controls ground/void permission, engineered scaffold anchorage, self-rescue and refuge, mobile access/dropped-object checks, and mine handover. It carries separate contractor and mine signatures.
WHERE THIS MINE FORM IS USED
Use at every critical work-at-height phase. Enter Underground mine / site, Company, Area / equipment, Permit / work order, Supervisor and Host-mine work owner. Identify actual area, access arrangement, authorised people and valid host-mine stage permission.
FIVE ORIGINAL HOLD AND RELEASE STAGES
1. Mine ground/void-edge and special-access permit
2. Scaffold/anchor design and competent erection release
3. Rescue plan, self-rescuer and refuge route acceptance
4. Height-work/MEWP access and dropped-object checks
5. Dismantling, barrier restoration and host handover
HOW TO COMPLETE THE ORIGINAL FIELDS
Complete five source STEP / HOLD / STOP POINT entries as Hold, Release or N/A, with actual VERIFIER / RECORD evidence, time, signatures, competent engineering and access proof. Keep each stage closed before moving to the next.
CRITICAL STOP-WORK AND MINE RELEASE RULE
NO RELEASE IF a witnessed technical hold, required permit or mine acceptance is missing. A contractor release does not replace HOST-MINE RELEASE; stop where support, rescue or edge protection is uncertain.
WHY THIS EDITABLE SOURCE BELONGS IN A CONTROLLED FILE
This source Word form retains the original layout, printed record sequence and mine-specific evidence fields. Record observations, actual inspection results, signatures and current engineering approval. It cannot replace a mine-issued permit, rescue plan or statutory appointment.
BUY ONE SINGLE OR THE COMPLETE UNDERGROUND PACKAGES
This R12.95 AL-F01 editable Word original is included in the 371-document Underground Mining Checklist Package and complete 628-page Contractor H&S File. Buyers who own either complete collection should avoid duplicate purchases. Mine-controlled fall rescue, anchorage, engineered access and operator release always govern work.
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