Bartholomew County REMC

• Audit Title

• Conducted on

  Date

• Prepared by Ben Ludington

• Location
  Address

• Personnel

• Select date

  Date

Description of job

• Work Order #

• Energized or de-energized work

  Energized

  De-energized

  Combination of both

• Secondary or Distribution

  Secondary

  Distribution

  Combination of both

• Overhead or Underground

  Overhead

  Underground

  Combination of both

Job Preparation

• Job briefing was conducted and documented

  Yes

  No

  N/A

• Pre-trip inspection was performed on CMV

  Yes

  No

  N/A

• Pre-flight of aerial unit was performed

  Yes

  No

  N/A

• Energy source controls (LOTO) have been identified

  Yes

  No

  N/A

Personal Protective Equipment

• Hard hat worn properly and in good condition

  Yes

  No

  N/A

• Eye protection worn

  Yes

  No

  N/A

• Proper hand protection

  Yes

  No

  N/A

• Safety toed boots

  Yes

  No

  N/A

• Hearing protection available

  Yes

  No

  N/A

• FR clothing in good condition

  Yes

  No

  N/A

• Rubber gloves worn and inspected prior to use

  Yes

  No

  N/A

• Rubber sleeves worn and inspected prior to use

  Yes

  No

  N/A

• Fall protection (buck squeeze - bucket truck harness)

  Yes

  No

  N/A

Grounding

• Truck grounds are being used and in good condition

  Yes

  No

  N/A

• Personal grounds are being used and in good condition

  Yes

  No

  N/A

• Conductor was tested prior to grounds being installed

  Yes

  No

  N/A

Vehicles

• Diggers/Buckets are properly set up

  Yes

  No

  N/A

• Wheel chocks are being used

  Yes

  No

  N/A

• All material on the vehicle is properly stowed

  Yes

  No

  N/A

• Outrigger pads are being used

  Yes

  No

  N/A

• Reverse alarm is in working order

  Yes

  No

  N/A

• Correct Fire Extinguishers available and inspected

  Yes

  No

  N/A

• First aid kit is stocked and location is properly marked

  Yes

  No

  N/A

• AED is available and location is properly marked

  Yes

  No

  N/A

Traffic control

• Beacon/strobe lights are working and being used

  Yes

  No

  N/A

• Traffic cones are used and properly placed

  Yes

  No

  N/A

• Road signs are adequate for the job being performed

  Yes

  No

  N/A

• Reflective vests are worn

  Yes

  No

  N/A

• A flagger is being used to control traffic

  Yes

  No

  N/A

General work practices

• Proper tools are being used to complete the task

  Yes

  No

  N/A

• Tools have been inspected and are in good condition

  Yes

  No

  N/A

• Live line tools have been inspected prior to use and tested within 1 year

  Yes

  No

  N/A

• Hand lines are available and in good condition

  Yes

  No

  N/A

• Ladders have been inspected and are in good condition

  Yes

  No

  N/A

• Excavations are safe and properly shored

  Yes

  No

  N/A

• Poles are tested prior to climbing

  Yes

  No

  N/A

• Adequate cover-up material is being used

  Yes

  No

  N/A

• Employees performing hot work are being observed by a safety watcher

  Yes

  No

  N/A

• Guards are in place on tools and equipment that need them

  Yes

  No

  N/A

• Clear communication is exchanged among crew members

  Yes

  No

  N/A

• Employees can explain direction of feed and closest protection device

  Yes

  No

  N/A

• Employee in charge

  Sign