NSW Resources RegulatorHEALTH CONTROL PLAN // IMPLEMENT

Health action and review plan record sheet

NSW mining and extractives industry yMine name:       Section:       Date:      

Person responsible for updating plan:       Induction updated (date):      

Hazard and source Control measure

Maintenancerequirements

List risk management

or work procedures for

review

Training requirements

Exposure monitoringrequired?

Yes/no

Health monitoringrequired?

Yes/no

Reviewdate

Responsibleperson

                                                     

                                                     

                                                     

                                                     

                                                     

Management sign-off: Date: