367 - AW-T01 | Mine Cleaning Technical Inspection & Acceptance Record
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UNDER GRD MINE — ORIGINAL EDITABLE WORD R12.95
AW-T01 — WHAT THIS ACTUAL MINE FORM DOES
A cleaned underground mine workface requires more than a verbal completion statement. AW-T01 is the actual editable technical inspection and acceptance record: seven evidence checks, source revisions or measured results, defect/reinspection references and separate contractor/mine sign-off responsibilities.
WHERE AND WHEN TO USE THE ORIGINAL
Use AW-T01 to document mine-zone cleaning, jetting, dust-control or waste-service close-out requiring a formal technical check. Identify MINE / AREA / LEVEL, WORK ORDER / MINE ZONE, DATE / SHIFT / PERMIT and CONTRACTOR SUPERVISOR; every result must relate to the actual location, approved method and controlled work order.
SEVEN SOURCE EVIDENCE CHECKS
1. Mine area owner accepts clean condition, remaining waste and restored equipment
2. High-pressure jetting requires dedicated line isolation, hose integrity and exclusion zones
3. Waste categories, containers and transfer records traceable to surface disposal
4. Wash water and sludge managed to avoid dewatering or water-quality impairment
5. Cleaning does not damage support tags, sensors, cable protection or fire barriers
6. No use of solvents, polishers or water methods outside approved material procedure
7. Dust, silica, diesel particulate and chemical exposure control defined
HOW TO COMPLETE THE SOURCE FIELDS
The four original columns are #, MINING-SPECIFIC ITEM / EVIDENCE TO TRACK, DOCUMENT / RESULT / MEASURED VALUE and DATE / AUTHORITY / STATUS. Record actual documentary sources, their revisions, measured/observed results and responsible authority. The form specifically tells users not to leave unexplained blanks and to retain certificates, test sheets and approvals.
SITE INTERFACE AND COMPETENT RELEASE
The mine operator controls zone, permit and return-to-service release. Technical record acceptance must be supported by actual evidence, defect close-out and relevant host-mine signatories; it is not independent statutory certification.
R12.95 WORD SINGLE OR FULL UNDERGROUND COLLECTION
This R12.95 Single is the original editable AW-T01 Word file. It is also in the 371-form Underground Mining Checklist Package and 628-page full Contractor H&S File. Existing owners need not buy twice; valid mine permits remain essential.
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