|
Announced
Unannounced |
Test Person | Sto |
| Auditor | Job Activity | |
| 2024-04-18 | Somewhere | Another Person |
| Date | Location | Supervisor |
| Time: 21:18:00 | Safe Zone" Coordinator | |
| Time |
| Employees |
|---|
| 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 |
| 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) |
| 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 |
| 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 |
| Item | Yes | No | N/A | Notes |
|---|---|---|---|---|
| Pre-Job Briefing (Send Weekly) | ||||
| Stretching Exercise (Daily) | ||||
| Weekly Safety Mtgs. (Send Weekly) |