Fillable NATIONAL BENCH CONTEST - DISCOUNT CARD (Mine Safety and Health Administration)

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NATIONAL BENCH CONTEST - DISCOUNT CARD (Mine Safety and Health Administration)

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Notes
Name of Participant
Contestant Number
NATIONAL BENCH CONTEST - DISCOUNT CARD
DRAEGER BG-4
Working Time
Minutes
Seconds
:
SIGNATURES:
Timekeeper:
Written Examiners:
Judges at Bench:
Scorecard Examiners:
Chief Judge/Appeals Committee:
U. S. Department of Labor
Mine Safety and Health Administration
Coal Mine Safety and Health
2019
A. Competition at Bench
Discount x Occurrences = Total
1. Failure to verbally identify each test being
conducted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
x =
2. Failure to verbally identify each problem . . . . . . . .
x =
3. Failure to correct each problem . . . . . . . . . . . . . . .
4. Failure to conduct any visual examination or test
on the BG-4, each test . . . . . . . . . . . . . . . . . . . . . .
x =
5. Failure to tighten connections properly during
assembly or testing, each connection . . . . . . . . . .
x =
6. Failure to comply with rules not covered in
discount sheet, each infraction . . . . . . . . . . . . . . . .
x =
B. Visuals
1. Failure to conduct a proper visual examination of
the frame/harness (Maximum - 4 points) . . . . . . . .
x =
2. Failure to conduct a proper visual examination of
the breathing bag (Maximum - 4 points) . . . . . . . .
x =
3. Failure to conduct a proper visual examination of
the O
2
cylinder (Maximum - 4 points) . . . . . . . . . . .
x =
4. Failure to conduct a proper visual examination of
the regenerative canister (Maximum - 3 points) . . .
x =
5. Failure to conduct a proper visual examination of
the relief valve . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
6. Failure to conduct a proper visual examination of
the cooler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
7. Failure to conduct a proper visual examination of
the hoses (Maximum - 2 points) . . . . . . . . . . . . . . .
x =
8. Failure to conduct a proper visual examination of
the coupling, inhalation and exhalation valves . . . .
x =
9. Failure to conduct a proper visual examination of
the facepiece (Maximum - 4 points) . . . . . . . . . . . .
x =
10.Failure to have visual apparatus fully assembled
(ready to use) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
C. Tester
1. Failure to conduct a proper low pressure warning
test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
x =
2. Failure to conduct a proper inhalation valve test . .
x =
3.
Failure to conduct a proper exhalation valve test . .
Discount x Occurrences = Total
4. Failure to conduct a proper drain valve test . . . . . .
5. Failure to conduct a proper leak test with positive
x =
pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Failure to conduct a proper relief valve test . . . . . .
7. Failure to conduct a proper high pressure leak
test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x
x
=
=
x =
8. Failure to conduct a proper constant metering
valve test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
9. Failure to conduct a proper minimum valve test . .
10.Failure to conduct a proper bypass valve test . . . .
11.Failure to conduct a proper low pressure warning
x
x
=
=
test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x =
12.Failure to conduct a proper battery test . . . . . . . . .
13.Failure to have test apparatus fully assembled
(ready for use) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
x
x
=
=
Bench Discount
Written Examination
x =
1. For each incorrect answer . . . . . . . . . . . . . . . . . . .
Total Discounts
2
5
5
5
1
2
1
1
1
1
1
1
1
1
1
2
2
2
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
2
2
2
2
2
2
2
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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NATIONAL BENCH CONTEST - DISCOUNT CARD (Mine Safety and Health Administration)

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Completed 7 August 2020

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