General Information
Audit Type
GPS Location
Latitude Longitude  
Crew
Additional Crew
Vehicle / Equipment
Item Yes No N/A Notes
Proper Vehicle Placement
Wheel Chocks in Use
Outriggers in Use
Warning Lights in Use
Traffic Signs Used and Proper Placement
Traffic Cones
Bucket Liner
Cleaning & Testing Log Book
Vehicle Inspection Book (Up-To-Date)
Backup Alarms
Personal Protective Equipment
Item Yes No N/A Notes
Hard Hat
Safety Glasses
Face Shield
Fire Retardant Clothing
Safety Toe Boots
Leather Work Gloves
Traffic Vest
Rubber Gloves
Rubber Sleeves
Fall Protection (Use & Inspection)
Hearing Protectors
Hand Line / Safety Line
Air Monitoring / Sniffer
Slings Inspected (Condition Acceptable Y/N)
Work Area
Item Yes No N/A Notes
Flagman
Stop/Slow Signs
Keep Pedestrians Out of Harms Way
Communication Available
Work Area Guards / Barriers
Atmospheric Test Equipment
Material/Equipment Storage
Area Policed After Job Completed
"Safe Zone" Established
Safety Equipment
Item Yes No N/A Notes
First Aid Kit (Up To Date)
Fire Extinguisher (Monthly Inspection)
Rubber Hoses/Rubber Blankets
Pole Guards
Ground Truck/Barricade
Switching & Tagging
Confined Space Rescue Equipment
The Job
Item Yes No N/A Notes
Pre-Job Briefing (Send Weekly)
Stretching Exercise (Daily)
Weekly Safety Mtgs. (Send Weekly)
Comments