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
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
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