Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Driver Name

DOT inspection book/ Log book

  • Xata login complete?

  • DVIR complete and up to date?

  • Spill kits, accident kit, fire extinguisher,warning triangles

Driver appearance and personal safety

  • Proper uniform worn?

  • Wearing steel toe shoes?

  • Is the driver using the gold standard items (safety cutter, gloves)

  • If the answer to above is No, has a coaching moment taken place?

  • Stretches at or before first stop, stretches routinely during shift?

Driving Habits

  • Follows driving laws and regulations?

  • Driver refrains from using phone/ texting while driving?

  • Maintains appropriate speed?

  • Maintains proper lane discipline and makes safe lane changes?

  • Maintains appropriate following distance?

  • Driver refrains from eating, drinking, smoking.

  • Courteous and defensive driving techniques?

Parking habits

  • Selects parking to ensure no backing?

  • Parks in designated parking area and does not block handicap bays?

  • Uses safety cones?

  • Truck locked/ bay doors down/ rear door down?

Lift gate safety

  • Mounts/dismounts lift gate safely ( lift gate all the way down, uses safety cones as necessary)

  • Uses safety flap?

  • Does not overload the lift gate?

Pallet jack safety

  • Operates pallet jack safely ( horn, walking to the side, load stable)

  • Positions pallet jack to minimize obstruction?

  • Empty pallets, shrink wrap, trash not creating obstruction or hazard?

Product delivery

  • Down stacks to minimize obstruction?

  • Uses safe lifting techniques (MoveSmart)

Hand truck use

  • Safely utilizes hand truck?

  • Clears a path to cooler and inside cooler before moving product?

  • Safely handles kegs?

Truck appearance

  • Cab and trailer are clean?

  • Pallets are separated by category, size and condition?

  • Equipment stowed safely?

Customer service

  • Accounts properly communicated with?

  • Customer concerns properly addressed, sales department contacted if necessary?

  • Driver comments

  • Supervisor signature

  • Supervisor notes

  • Driver signature

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.