• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Nose #:

  • Flight #:

  • Gate:


  • PPE Worn - (Ear Protection, Safety Vests)?

  • Safety Zone Clear?

  • Proper Arrival Procedures Followed?

  • Aircraft Chocked Properly?

  • Proper Hand Signals Used?

  • Towbar Connected According to Procedures?

  • Proper Cone Placement?

  • Safety Stops Performed?

  • FWD/AFT Beltloaders Positioned Correctly?

  • FWD/AFT Beltloaders Chocked Correctly?

  • Lavs Completed According to Procedures


  • Gate Services Disconnected According to Procedures?

  • Walkaround Completed Prior to Push?

  • Guide Agent Following Procedures?

  • Aircraft Pushed According to Procedures?

  • Proper Pushback Disconnect Procedures Followed?

General Ramp Procedures

  • Proper Driving Procedures Followed?

  • MP3/Cell Phone Policy Followed?

  • MP3/Cell Phone used while driving on service road?

  • FOD Walk Performed prior to A/C Arrival and Push?

  • FOD Present in General Ramp Area?

  • Agent Riding Belt In/Out of Bin?

Comments and Notes

  • Comments:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.