This form is used by employers in the mining sector to notify a Ministry of Labour inspector before a test drill is operated at the surface to prove mineral bearing substances, rock, earth, clay, sand or gravel.

This form is used by mining companies to notify the Ministry of Labour of reportable incidents as identified in section 53 of the Occupational Health and Safety Act and section 21(5) of the Regulation for Mines and Mining Plants. It includes notification of groundfall or rockburst and vehicle incident or fire.