Underground Work Monitoring Log Form
Use this form to record and monitor all aspects of underground work activities, safety conditions, and observations.
Work Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift
*
Morning
Afternoon
Night
Other
Site or Tunnel Location
*
Crew/Worker Names
*
Supervisor Name
*
Work Activity Description
*
Monitoring Observations
*
Air Quality or Ventilation Status
*
Good
Adequate
Poor
Not Measured
Gas Detection Readings/Status
*
Normal
Elevated
Alarm Triggered
Not Available
Equipment/Tools in Use
Ground or Structural Condition
*
Stable
Minor Cracks
Major Cracks/Movement
Water Ingress
Other
Incidents or Hazards Encountered
*
None
Slip/Trip/Fall
Equipment Malfunction
Gas Leak
Structural Instability
Other
Corrective Actions Taken
Notes/Remarks
Submit Log
Should be Empty: