300 - AS-C03 | Refuge Condition Change & Emergency Protection Checklist
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UNDER GRD MINE — ORIGINAL EDITABLE WORD | R12.95
AS-C03 — REFUGE CONDITION CHANGE & EMERGENCY PROTECTION CHECKLIST
AS-C03 is the actual seven-check change-of-condition and emergency protection checklist for mine refuge or rescue facilities. It starts with signed mine emergency-control restoration and updated maps, making changed system status an explicit review requirement.
WHERE THIS UNDERGROUND SOURCE IS USED
Complete it after changed refuge availability, isolation status, shift, life-support test result or mine emergency instruction. Record MINE / AREA / LEVEL, WORK ORDER / MINE ZONE, DATE / SHIFT / PERMIT and CONTRACTOR SUPERVISOR against current mine COP/SOP and operator limits.
SEVEN ACTUAL WORKFACE CHECKS
1. Mine emergency control signs restoration and updates maps/muster instructions
2. Witnessed communication, alarm and life-support functional test completed
3. Rescue equipment remains available and competent responders are briefed
4. Refuge seals, pressure integrity, emergency lighting and gas monitors inspected
5. Self-rescuer issue, condition and training interfaces verified with mine records
6. Before isolation, alternative escape/refuge capability approved for affected district
7. Life-support oxygen, CO2 removal, water and communications services secured
HOW TO COMPLETE THE SOURCE WORD RECORD
The printed WORKFACE VERIFICATION / REQUIRED CONTROL table has Y, N, N/A and EVIDENCE / DEFECT / ACTION. For seven actual source entries, mark observed status, explain every NO and N/A and attach reliable work-order or inspection evidence. It is not a permit.
SOURCE-SPECIFIC SAFETY AND RELEASE CONTROL
A signed restoration note is not sufficient if an alarm or life-support functional test fails. The source HOLD rule stops work when mine clearance, emergency protection or critical proof is absent, and demands reassessment after a shift or condition change.
OPERATOR CONTROL AND HANDOVER SIGNATURES
The source's review block records evidence references, contractor supervisor and host mine authority signatures where required, and actual Date / release reference. A signed checklist does not grant authority.
THE WORD SINGLE OR COMPLETE UNDERGROUND COLLECTIONS
This source-identical editable AS-C03 Word form is R12.95 and already included in the 371-document Underground Mining Checklist Package and complete 628-page Contractor H&S File. Owners of either complete product should avoid purchasing twice. Current mine emergency COPs, permits and written approval govern all work.
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