Title Page
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Company:
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Client / Site:
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Prime Contractor:
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Work Site:
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Conducted on:
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Auditor:
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Faller:
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Supervisor:
Falling Check List
Training Records
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Faller's log book and wallet certification
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Trainee's training records
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First aid tickets
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S100 fire training
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Other
Shutdown Criteria
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Rain
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Wind
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Snow
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Fog
Starting New Falling Area
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Pre work sign off
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Site-specific hazards
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Road/Block signage
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Site hazard assessment sign off
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Block access and egress, walk in and out or heli
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Are there other crew's working in area?
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Do you know radio channel for other crew's
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Alternate radio channel for crew?
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Fire equipment location
Knowledge of ERP
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Who are the level 3 FAA
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What level 3 FAA is closest to you
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Location of ETV or Heli
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Closest Heli Pad
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Closest Hospital
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General Comment
Faller Check List
Safe Work Procedures
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Man-check
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Reporting an incident
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Double up procedures
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Two tree length rule
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8 Deadly sins
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Road's gated
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Daily work plan signed
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Jacking tree's
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Over coming falling difficulty
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Get second opinion
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Run-away potential
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Trails ribboned and cut
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Condition of up set
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Understanding your map and prescriptions
Faller PPE
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Photo
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Hard Hat and ear muff's
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High visibility shirt & rain gear
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Eye and face protection
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Hearing protection
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Leg protection & footwear ( Caulk Boots )
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Two way radio and whistle
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Pressure bandage
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Fire extinguisher
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Gloves
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3 Wedges
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3.5 lbs with min 17" handle axe
Observed Falling Workmanship
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Photo
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Working on high side
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Assessing for hazards and danger trees
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Saplings fell first
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Under cut cleaned out
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Sight lines being used
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Trees fell to prevent brushing of other timber
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Back-barring used to clean off stump pull
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Use of eye protection
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Good Housekeeping
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Brushing out, escape trails cut
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Working the face
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Safe working distance
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Keep heads up
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SHA demonstrated
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Plan with partner
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Falling plan and plan for hazards
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Clears away 10 ft or adequate cover
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Checks and re-checks canopy
Observed Liming and Bucking
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Photo
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Check canopy for overhead hazards
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Uses face screen when limbing
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Cuts limbs flush
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Chooses lengths for safe bucking
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Controls tape rewind with face screen down
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Set chain brake when walking back after bucking
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Checks for pivot points
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Identify binds
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Limbing technique
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Matched cuts
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Avoids breakage
Saw
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Photo
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Palm lock, chain brake, ign, switch
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Adequate bar length
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Muffler with spark arrest
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Chain brake works
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Sharp chain
Safety / Tools
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Spare Saw
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Full size axe 3.5 lbs 27" handle
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Spare bar
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Spare tap and tool kit
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NWZ and trail ribbon
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Min 2 spare wedges
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Has water and food
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General Comment
Stump Audit 1
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 2
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 3
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 4
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 5
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 6
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 7
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 8
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 9
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Stump Audit 10
Falling Stump Audits ( inches )
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Species
- Cedar
- Cypress
- Hemlock
- Balsam
- Fir
- Alder
- Maple
- Other
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Diameter
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B/C
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U/C
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U/C Depth % = uc / ( UC + BC )
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Undercut Opening
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Backstep Highside
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Backstep Lowside
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Photo
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Pass or Fail
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Comments
Falling Stump Audit Signature
Falling Stump Audit
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Faller Signature
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Auditor Signature
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Additional Comments
