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Date: A Location: - shot#: Z �� <br /> BLASTER'S CHECKLIST Must be filled out as you go <br /> yss/no/NA PRE-TRIP CHECKLIST <br /> yes/no/NA <br /> Measuring Tapes and lead ends .�- Oriilers log{if faxed prior to shot) <br /> Burden pole Shot r <br /> Pa erwork and Hold Harmless Load_blocked and braced <br /> S ices Loa ' Poles!T Bars <br /> Starter and primers Density Cu and Scales <br /> Blast in Signs&cones Two Way Radios <br /> r Sirens In world order ,r Radice full Radios <br /> ed <br /> Seismographs Wheel Chocks <br /> Cha <br /> Pain!Set bade Stakes Harness&Lanyard <br /> First Aid Kits <br /> ✓ camera and tape for specific acct. f PPE <br /> yes/na/uA PRESHIFT CHECKLIST <br /> Inspect blast area for Unsafe Worki Conditions(indudin face)for voids,cracks,caves,etc.. <br /> r� Ensure aN ern ees have their site specific training. <br /> ✓ Secure blast site with wami signs and cones(includi22 floor In front of face) <br /> 00, Mark fall zone area at least slx(6 feet from the crest <br /> ✓ Inspect Harness/Lan and before each use if needed for fail zone or top of trucks <br /> ✓ AU equipment-back up alarms rational <br /> so' Measure front row burden with burden pole or profilgr <br /> ✓ Check drill I and all holes for proper depth end-blockage <br /> Insure all needed products are present-enau h boosters,detonators etc <br /> Voor Insure blast design Is consistent with closest structures requirements <br /> .� Check shot access includinq traffic activity <br /> Any need for calling assistance(Hold Harmless,equi equipment to dose,drilling problems,etc...) <br /> ef Conduct pre-blast safe meek with bust crew and customer blast coordinalt*mdude name,txerow) <br /> Item covered tat y <br /> 1)4 A n <br /> i <br /> yes/ncINA TIE-IN CHECKLIST <br /> Shot tie inspected and signed off by-two persons prior to s_t includina lead li names below) <br /> Blast area is clqiredand blocked before�atta;!ing Starter cap and lead line <br /> Blaster in char a in communication with all guards at this time <br /> Blaster in charge will insure blast area has been cleared and guarded before the siren Is sounded <br /> ✓' Afler proper walling time blaster in cha a win contact a4 guards before lhn blast <br /> I.-wr✓ Seismograph located at nearest off site structure or at the Prope Line <br /> Was the shot video taped <br /> Reason for not videoing: <br /> yeS/no/!vA POST BLAST CHECKLIST <br /> Maintain auards until shot is cleared and"all clear"is sounded <br /> Check for misfires,undetonated explosives or burning product and other dangers <br /> ✓ Sound all dear that is audible to all parties <br /> Dispose of lead line in approved manner <br /> Dispose of empty boxes in approved methods onl <br /> Complete all paperwork prior to leavi site-delivery ticket,return bill of fading9lastees checklist <br /> S <br /> cup densities 1st 12nd 3ro <br /> Final Density <br /> c9 Amount of water used in repump operations <br /> Make one final check of blast site before Isavin property to insure no materials have been left <br /> and that no hazards are present that may have been missed dunng clearing process <br /> Must be completed and turned in de#y Blaster In Charge <br />