• Audit Title

  • Site Name

  • Conducted on

  • Auditor

  • Location
  • Site EHS Manager

Applicable Standards

  • Select those standards that apply.

Documents Reviewed

  • Written Program

  • Powered Industrial Vehicle Surveillance Records

  • Training Program

  • Training Records

  • List of PIV operators

  • Accident or near miss investigations

  • Site specific documents

Program Execution

  • Is there an IOSS program leader on site?

  • How many people operate PIVs?

  • Are PIV operators removed from driving PIV's until retrained if they are involved in an accident or near miss?

  • Are the PIVs on a PM program?

  • Were there any accidents or near misses associated with PIVs? If yes, review and provide outcome of investigation to prevent re-occurance.


  • What is the frequency of training?

  • Does the training program cover the required program elements?

  • Describe the training program.

  • Who serves as the certified trainer?

  • Are operators re-trained upon any of the following: Operator is observed operating in an unsafe manner; Operator is involved in an accident or near miss; Operator receives an evaluation that they are not operating the truck in a safe manner; Operator is assigned to a different type of PIV; or a condition in the workplace changes in a manner that could affect safe operation of the truck.

Medical Evaluation

  • Is the list of participants in the PIV medical surveillance program aligned with the list of employees who operate PIVs?

  • What is the system for notifying those who operate PIVs when they are due for medical surveillance?

Employee Discussions

  • Discussions were held with the following groups or employees on site. List number of people when applicable.

Plant Tour

  • Were operators observed wearing seat belts?

  • Are pre-use inspections conducted and documented on every shift? (review completed inspections)

  • What is the process to address repairs or unsatisfactory conditions identified on the pre-use inspection checklist?

  • Is there a process to remove a PIV from service if a pre-use inspection identifies an unsafe condition or PIV in need of maintenance?

  • Describe process for removing PIV from service.

  • Are dock locks and / or chocks engaged prior to PIV's entering trucks or trailers?

  • Are jack stands used with trailers that are not connected to trucks?

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