Mining Operation Dispatch Checklist Form
Complete this checklist to ensure all operational dispatch procedures for mining activities are followed. All items must be reviewed prior to dispatch.
Date of Dispatch
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift
*
Please Select
Morning
Afternoon
Night
Dispatcher Name
*
First Name
Last Name
Operator Name
*
First Name
Last Name
Equipment or Vehicle Assigned
*
Pre-Start Safety Check Completed
*
Yes
No
Two-Way Radio/Communication Checked
*
Yes
No
Emergency Equipment Present
*
Yes
No
Notable Incidents or Hazards (if any)
Dispatch Checklist Completed By
*
First Name
Last Name
Submit Checklist
Should be Empty: