1. Answer questions provided below.
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Actions click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link.
First Aid Supplies
Eye Wash Solution & Bottle
Signs & Cones
Forestry Fire Pack
First Aid Identifier
Site Access / Egress
Emergency Contact Number
Adequate Foot Protection
H2S Monitors (calibrated, daily test)
Tools, Pumps, Gasoline, Oils
Hazard Labels (bins &containers)
Food & Water
Did the contact issue a safe work permit?
Did the crew visually check the work site forhazards?
Did the crew document a work plan? (A signed tailboard plan)
Can all crew members describe the emergency response plan?
Are all crew members concerns addressed onthe tailboard?
Limits of Approach Known By Crew
Does the crew have a J.S.A.?
Is the J.S.A. signed by clients?
Does the crew have a copy of their last safety meeting?
Does the crew have a copy of their last safety inspection?
Pesticide License (for province)
ATV or ORUV
UTT or UTW
Heavy Equipment Operator (Approved)
Back Up Alarm
Condition of the Tire Tread
Spare Tire/ Tire Wrench
Rotating Warning Light
Trailer hitch and chains
Trailer Dynamite Switch
Break Away Switch
Cab is Clean
Regulator & Gauges
Hoses, reels, & Guns
Clean Inside / Outside
Did the crew document the correct amount of herbicide before they decanted it into the tank?
Are all pesticide containers labeled?
Did the crew wear the required PPE when measuring and mixing?
Did the crew measure the correct quantities of herbicide?
Did the crew follow safe mixing procedures? (i.e.- not near water)
Did the crew triple rinse empty herbicide containers?
Did the crew clean up spills and dripping containers before putting them away?
Did the crew follow correct procedures for mounting and dismounting the spray unit?
Are Club root Protocols Available if needed?
Is equipment Cleaned Prior to arriving at site?
Is a record available?
Crew ensures that no chemical has gone off site?
Is there a water body within 30 meters?
Weather station available? (Kestrel)
Did the crew measure the site before mixing?
Did the crew measure all aspects of the site?
Did the crew draw the maps neat & accurate?
Did the crew wear the required PPE?
Was the crew aware of their surroundings and the hazards?
Did the crew follow a logical pattern to ensure that they sprayed the entire site?
Did the crew complete a calibration after spraying the site?
Did the crew deliver good coverage?
Did the crew achieve their application rate?
Are there any leaks in the spraying system?
Did the driver and the sprayer both watch for hazards when the truck was moved?
Did the sprayer and his assistant communicate work plans together?
Did the crew complete all the paper workneatly and accurately?
Maps, weather, herbicides, rates
Did the crew prepare for the next work site?
Did the crew depressurize the gun before disconnecting it?
Did the crew do this on the treated area so that any spillage would not cause off site damage?
Did the crew follow procedures to shut down the spray system?
Did the crew shut off the fuel switch?
Did the crew lock all bins?
Did the crew label the contents of the tanks?
Did the crew leave the work site clean and tidy?
Is the crew maintaining adequate contact with the client?
Is the crew keeping the client up to date on their progress?
Are the crew members friendly and responsive toward the client?
Is the client happy with this crew?
Results Discussed With Crew?