This form is used by constructors to notify the Ministry of Labour, before work is begun at a construction project, if the project includes work on a trench more than 1.2 metres deep into which a worker may enter.

This form is completed by employers, as required by section 182 (1) of the Regulation for Mines and Mining Plants, before diesel equipment is first used in an underground mine The completed form must be kept readily available at the mine site.