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MINING AND QUARRYING SAFETY & HEALTH ACT 1999 (MQSHA)

NOTIFICATION OF APPOINTMENT OF AN UNDERGROUND MINE MANAGER

I,……………….……………………………………………………...............................................……………....……, the SSE for the mine known as:

……………………………………………………….…………………………………………………………………………... with Mine ID Number: MI…………………

V210603

(Print Name)

give notice of the appointment of the following person as the underground mine manager:

DETAILS OF UNDERGROUND MINE MANAGER (as defined in MQSHR, s53, 54)

NAME:

CONTACT DETAILS: Phone: Mobile:

Email:

Residential Address:(where nominee resides not place of employment)

Residential Postal Address: (if different from residential address)

TYPE OF APPOINTMENT: (Tick whichever is applicable)

Permanent Start date:

Temporary** Start date: End date:

Start time: End time:

* If 20 or more persons work underground, the Underground Mine Manager must have a first class certificate ofcompetency for an underground mine.** Every operating underground mine must have a permanent Underground Mine Manager. The temporaryappointment is the appointment of a person to act as Underground Mine Manager during the absence of thepermanent Underground Mine Manager (MQSHA, s54).

The position is placed in the management structure of the mine to enable the appointed person to control and manage the underground mine and the person is aware of their responsibilities as the underground mine manager.

As the Site Senior Executive, I confirm that the above named person has the competencies as prescribed by the Mining and Quarrying Safety and Health Advisory Committee.

Signed: ____________________________________ Date:______________ (Site Senior Executive)

South Region GPO Box 1321 BRISBANE Q 4001 P (07) 3330 4272 sthmines@rshq.qld.gov.au

North Region PO BOX 22 TOWNSVILLE Q 4810 P (07) 4447 9248 tsvmines@rshq.qld.gov.au

North West Region PO BOX 959 MOUNT ISA DC Q 4825 P (07) 4745 4114 isamines@rshq.qld.gov.au