Title Page
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Area OSM name:
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ALA/AIC name
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Conducted on
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Shift AM/ PM
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Area: T4, T2, DC, PAD, or A-side
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Gate, Service Road or Bagroom
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Gate Number
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MU Number
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Gate, Service Road or Bagroom
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Gate Number
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PAD Number
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Gate Number
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Prepared by
TYPE OF OPERATION
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What process is currently being observed?
- REAL-TIME OBSERVATION
- MAINLINE ARRIVAL
- MAINLINE DEPARTURE
- DC ARRIVAL
- DC DEPARTURE
- BAGROOM
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What is being observed?
- Agent stepping over tongue or towbar
- Baggage cart / Can curtains were not secured
- Bin webbing (Hanging outside of aircraft or not secured prior to aircraft departure)
- Business Partners
- Damaged transporter/cart being used (locks, hitch, curtains, and tires)
- Electronic device being used in operation
- FOD not picked-up (Make-up Unit, conveyances, Tugs, Beltloader, FMC, Push-Back Rig, during ARR/DEP process)
- Improper bag lifting, agent didn’t ask for help with heavy bag or item
- No conveyances check for out of limit damages
- No PPE (Safety vest, Steel toe, Hearing protection)
- No Safe driving (seat belt, speed limit, bags on tug, and extremities outside vehicle, pushing GSE with GSE)
- PVI not done on GSE
- Transporter/cart tongue Not in locked position
- Unsecured GSE/Vehicle (Missing chocks on belt loader, hand brake down)
- Other
- Water hose is not retracted and capped after use
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GSE number?
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Additional information on observed improper lifting technique?
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Aircraft tail number?
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Agents present?
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Attach a photo?
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Water hose not retraced, not capped, or both?
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Attach a photo?
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Choose connected transporters or carts tongue, or towbar?
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Choose Transporter or Cart?
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Provide GSE Number
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Is this equipment damaged?
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Is this equipment being taking out of service?
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Add photo
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What type of PPE is missing?
- Hearing protection
- Safety vest
- Steel toe shoes
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Is the agent currently driving a GSE?
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Additional notes?
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Attach a photo?
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What safe driving behavior that was observed?
- Seat belt
- Speed limit
- Did not stop at designated stop sign
- Driving on opposite side of established roadway
- Bags on tug
- Extremities outside vehicle
- Pushing GSE with GSE
- Driving under jet bridge
- Drove GSE over water hose
- Other
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What safe driving infraction was observed?
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Attach a photo?
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FOD observed at or on?
- Belt Loader
- Conveyances
- During Arrival process
- During Departure process
- FMC
- Make-up Unit
- Push-Back Rig
- Tugs
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Provide GSE Number
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Location of Make-up Unit
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Attach a photo?
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Choose Transporter or Cart?
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What is damaged?
- Locks
- Hitch
- Curtains
- Tires
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Provide GSE Number
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Attach a photo?
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What electronic device was being used?
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Attach a photo?
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Which Business partner?
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Indicate what safety behavior was observed:
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Attach photo
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Is GSE/Vehicle inside safety zone?
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Was the GSE/Vehicle facing the aircraft?
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Choose: Missing Chocks, Handbrake down, or Unattended?
- Missing Chocks
- Handbrake down
- Unattended
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Provide GSE/Vehicle Number
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Attach a photo?
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What safety infraction was observed?
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Attach a photo?
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Flight Number:
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Ship Number:
PROTECTIVE SAFETY EQUIPMENT
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Are all agents wearing PPE? (Hearing Protection, Safety Vest, Steel Toe Shoes)
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Which of the following PPE was observed missing?
- Hearing Protection
- Safety Vest
- Steel Toe Shoes
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Did you observe an agent(s) use their personal electronic devices in the operation?
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Where electronic devices are being used?
PRE-ARRIVAL
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Is the boarding bridge properly positioned for the specific type of aircraft and both wheels are in designated stow box?
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Is the Safety zone clear? (Safety cone/nose gear chocks permitted to delineate stop line)
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Were the agents observed clearing the area of FOD as they go?
ARRIVAL
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Are wing walkers in position on the roadway, using proper hand signals and blocking the traffic?
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Are wing walkers using a pair of working and approved wands (lit wands at night)?
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Did agent placed a safety cone and/or nose gear chocks at the nose-gear stop point to assist with<br>designating aircraft stop point?
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Are wing walkers following the path of the wing tips into the gate?
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Was the aircraft parked utilizing (1) Marshaling Agent and (2) Wing Walkers?
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Is this a B737-900 aircraft, MD88/90 or B717, or other mainline aircraft type?
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Was tail-stand inserted before marshaling agent gave thumbs up to jet-bridge operator?
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Did agent completely unloaded Bins 3 and 4, and wait 8 minutes from aircraft block in prior to unloading forward Bins 1/2? (Gates claims can be removed within 8 minutes)
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Did marshaling agent give the all clear signal to the boarding bridge operator to move only after both main gears were chocked properly?
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Did marshaling agent chock the nose gear immediately after giving the all clear signal to the boarding bridge operator?
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Did marshaling agent provide chocks-in signal to the aircraft pilot? (After two sets of gear are chocked)
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Are chocks placed parallel to the axle and lightly touching the centerline of the tire?
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Wing walker agents observed off-loading only after chocking main gear?
OFF-LOAD
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Is beltloader conveyor bed and handrail in the stowed position while approaching the aircraft?<br>
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Did belt loader driver refrain from raising or lowering the conveyor belt while in motion?
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Did the belt loader come to a complete stop prior to entering "No Drive Zone" (Safety Diamond) when approaching aircraft?
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Did agents transition into/out of bins properly, by not riding belt loader or using conveyor bed as a lift?
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Is the belt loader touching aircraft? (Beltloader driver didn't respect 2" clearance)
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Is the belt loader positioned 8-10" above bin floor and not crossing door threshold?
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Is the belt loader chocked properly (front and back of a straight tire)?
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Is the belt loader chocked with the parking brake engaged during the entire unload process?
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Type of aircraft been serviced: Narrow-Body (B757, B737, B717, MD88/90, or A319/320/321) or Wide-Body (B767, B777, A330, or A350)
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What type of Narrow-Boddy is it?
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At anytime did agents walk under the fuselage of the aircraft?
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Is agent standing between beltloader and aircraft?
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Is the belt loader handrail up while it is being used to unload specific aircraft type?
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Which aircraft type is it?
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Did agent use yellow stairs to open cargo door panel on wide-body aircraft type?
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What did agent use to open cargo door panel in wide-body aircraft?
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Did container loader (FMC) driver come to a complete stop prior to entering "No Drive Zone" (Safety Diamond) when approaching the aircraft?
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Did container loader (FMC) clear of the cargo door swing area when opening the door?
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Is container Loader touching aircraft?
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Did agents avoid riding container loader platform as a lift?
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Is tug driver agent using transporters with working locks?
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Did transporters come in contact with the container loader (FMC) at any time?
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Did the upper loading bridge of (FMC) have two guide bars properly positioned during unloading of ULD’s.
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Did agent attempt to spin container (ULD) on upper bridge of FMC?
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Baggage tug in neutral and parking brake engaged?
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Did agents avoid operating or placing equipment within the 5 FT "No Drive Zone"?
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Are agent body extremities inside of the bin?
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Are bin webbings hanging outside of the bin during unload process?
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GSEs staged back into their designated staging area after unloading is complete (Including Tail Tip Pole for B737-900)?
WALK - AROUND
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Did the marshaling agent (or designated crew) begin walk around on 1st officer's side of the aircraft within 15 min of arrival?
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Were the safety cones properly positioned around aircraft?
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Did the marshaling agent connect the GPU and PCA?
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Was the power-in signal given?
ARRIVAL
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Is the area between gates clear from any GSE, Vehicles, or equipment prior to aircraft being marshalled-in?
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Are the wing walkers in position on the roadway, using proper hand signals and blocking the traffic?
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Are the wing walkers using a pair of correct and working wands (lit wands at night)?
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Was the aircraft parked with (1) Marshaling Agent and (2) Wing Walkers?
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Did marshaling agent chock the nose gear immediately after sending the all clear signal to the boarding bridge operator?
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Did marshaling agent provide chocks-in signal? (After nose landing gear is chocked)
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Are the main cabin door handrails lowered properly? (not stepping on the 1st step)
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Are chocks placed parallel to the axle and lightly touching the centerline of the wheel?
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Did the wing walker agents begin to off-load baggage after chocking main gear?
OFF-LOAD
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Is the belt loader conveyor and handrail in the stowed position while approaching the aircraft?
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Did belt loader driver avoid from raising or lowering the conveyor belt while in motion?
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Did belt loader come to a complete stop prior to entering the "No Drive Zone" (Safety Diamond) when approaching the aircraft?
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Did agents transition into/out of bins properly, by not riding belt loader or using conveyor as a lift?
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Belt loader not touching aircraft (2" clearance between yellow bumper and door sill)?
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Was the belt loader chocked properly (front and back of a straight tire)?
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Did agent stand between belt loader and aircraft?
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Agent body extremities are inside of bin?
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Did agents avoid operating or placing equipment within the 5 FT "No Drive Zone"?
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Were bin webbings hanging outside of the bin during load/unload process?
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GSE staged back into a designated staging area after unloading is complete?
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Did bag room driver drop off baggage cart between gates area?
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Was the beltloader chocked with the parking brake engaged during the entire unload process?
WALK-AROUND
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Did the marshaling agent (or designated crew) begin walking around on cargo bin side (Captain's side) of the aircraft within 15 min of arrival?
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Were cones properly positioned by aircraft type? (Including Nose Cone for CRJ)
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Does the aircraft have an INOP APU?
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Did the marshaling agent connect the GPU prior to walking around on CRJ aircraft?
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Was the PCA connected after the arrival walk around check and offload is completed?
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Were the ground power and air applied immediately after the aircraft was chocked?
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Was the GPU cord positioned behind NLG for all Delta Connection Aircraft?
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Was the power-in signal given?
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Is Delta Connection air panel secured?
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At anytime did agents walk under the fuselage of DC aircraft?
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At anytime did agents walk under the wing of DC aircraft? (Unless required to service the aircraft)
BOARDING BRIDGE OPERATION
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Did jet bridge operator refrain from moving the bridge without receiving clearance from ramp personnel?
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Did the jet bridge operator refrain from contacting the aircraft?
LOADING
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Are chocks placed parallel to the axle and lightly touching the centerline of the tire?
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Were the safety cones properly positioned around aircraft?
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Is the belt loader conveyor bed and handrail in the stowed position while approaching the aircraft?
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Did the belt loader driver refrain from raising or lowering the conveyor belt while in motion?
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Did the belt loader come to a complete stop prior to entering the "No Drive Zone" (Safety Diamond) when approaching the aircraft?
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Did agents transition into/out of bins properly, by not riding belt loader or using conveyor bed as a lift?
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Is the belt loader touching aircraft (Agent didn't leave 2" clearance between belt loader yellow bumper and cargo door sill)?
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Is the belt loader positioned 8-10" above bin floor and not crossing door threshold?
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Is the belt loader chocked properly (front and back of a straight tire)?
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Are bin webbings hanging outside of the bin during load process?
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Are Agent's body extremities inside of bin?
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Did agents avoid operating or placing equipment within the 5 FT "No Drive Zone"?
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Baggage tug in neutral and parking brake engaged?
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Is the belt loader chocked with parking brake engaged during the entire load process? Including jet bridge bags?
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Did agents refrain from removing the belt loader with bed and/or handrail in a raised position?
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Type of aircraft: Narrow-Body (B757, B737, B717, MD88/90, or A319/320/321) or Wide-Body (B767, A330, A350, or B777)
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Is agent standing between belt loader and aircraft?
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Did agents refrain from riding a moving belt or use belt loader conveyor bed as a lift?
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Is this a B737-900 aircraft type?
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Was the tail-tip-stand removed before agent started loading?
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At anytime did agents walk under the fuselage of the aircraft? (Unless required to service the aircraft)
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Is this a B717/MD88/MD90 aircraft type?
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Did agents refrain from loading any bags (including gate checks bags) without the use of a belt loader in the aft bin?
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At anytime did agents walk under the fuselage of the aircraft? (Unless required to service the aircraft)
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Is this a A319/320/321 aircraft type?
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Is the belt loader handrail up while it is being used to load bags and cargo into the bin?
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Is there at least a 2" clearance between bags and cargo ceiling in Narrow-body Aircraft?
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What aircraft type is it?
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Did agent use yellow stairs to close cargo door bin for this aircraft type?
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What did the agent use to close cargo door panel in wide-body aircraft?
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Did Container loader driver come to a complete stop prior to entering "No Drive Zone" (Safety Diamond) when approaching the aircraft?
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Is the container loader touching aircraft?
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Did agents avoid riding the container loader platform as a lift?
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Is the tug driver agent using transporters with working locks?
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Did the transporters come in contact with the container loader at any time?
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Did the upper loading bridge of (FMC) have two guide bars properly positioned during loading and unloading of ULD’s.
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Did agent attempt to spin container (ULD) on upper bridge of FMC?
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Did the container loader (FMC) clear of the cargo door swing area when closing the door?
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Is the belt loader handrail up while it is being used to load bags and cargo into the bulk-bin?
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Were all bins opened and checked?
FLIGHT CLOSE-OUT
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Are two people (Wing-walker and Push-rig driver) used during tow-bar connection?
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Is by-pass-pin being used on all aircraft (clip removed for MD-88/MD-90, B717)
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Are bin webbing secured in all bins prior to departure?
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Were GPU/Air conditioning disconnection communicated with Flight deck crew?
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Was the departure walk around conducted?
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Was the boarding bridge given clear signal (clear path) to move back?
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Are the chocks removed only after tow-bar and tractor are hooked up to the aircraft and brakes are set (Headset or Face to Face)?
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Did the ALA have a copy of the Load Report and Ramp Worksheet in his possession and have load report filled out accordingly?
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Did agents made an attempt to clear area from FOD as they go?
PUSH-BACK
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Is the safety zone clear of GSE prior to push-back?
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Are wing walkers using a pair of correct working wands (lit wands at night)?
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Are wing walker agents in position on the roadway, using proper hand signals and blocking the traffic?
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Did the push-back driver push the aircraft at walking speed?
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Is 3-points disconnect process being followed?
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Did the marshaling agent wait until all equipment & personnel were clear of the aircraft's path to give the "All Clear" salute to the flight crew?
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Did the crew return to the gate and prepare it for the next arrival (Cones, Chocks, Safety zone clear)?
LOADING
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Did bag room driver drop off baggage cart between gates area?
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Were cones properly positioned by aircraft type? (Including Nose Cone for CRJ)
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Are chocks placed parallel to the axle and lightly touching the centerline of the wheel?
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Was the GPU cord positioned behind NLG for all Delta Connection Aircraft?
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Is the belt loader conveyor and handrail in the stowed position while approaching the aircraft?
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Did belt loader driver avoid raising or lowering the conveyor belt while in motion?
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Did belt loader come to a complete stop prior to entering the "No Drive Zone" (Safety Diamond) when approaching the aircraft?
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Did agents transition into/out of bins properly, by not riding belt loader or using conveyor as a lift?
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Belt loader not touching aircraft (2" clearance between yellow bumper and cargo door sill)?
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Was the belt loader chocked properly (front and back of a straight tire)?
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Did agent stand between belt loader and aircraft?
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Agent body extremities are inside the bin?
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Did agents avoid operating or placing equipment within the 5 FT "No Drive Zone"?
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Were bin webbings hanging outside of the bin during load/unload process?
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Baggage tug in neutral and parking brake engaged?
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Was the beltloader chocked with parking brake engaged during the entire process including late bags and addition jet bridge bags?
FLIGHT CLOSE-OUT
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Are bin webbing secured in all Bins prior to departure?
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Are GPU/Air conditioning disconnection communicated with Flight deck crew?
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Departure walk around conducted?
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Is boarding bridge given clear signal (clear path) to move back?
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Are the main cabin door handrails rised properly? (not stepping on the 1st step)
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Are chocks removed only after tow-bar and tractor are hooked up to the aircraft and brakes are set (Headset or Face to Face)?
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Did agents make an attempt to clear the area from FOD as they go?
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At anytime did agents walk under the fuselage or the wing of the aircraft (Unless to service it)?
PUSH-BACK
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Is safety zone clear of GSE prior to push-back?
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Is the area between gates clear from any GSE, Vehicles, or equipment prior to push-back?
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Are two people (Wing-walker and Push-rig driver) used during tow-bar connection?
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Are wing walkers using a pair of correct working wands (lit wands at night)?
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Wing walkers in position on the roadway, using proper hand signals and blocking the traffic?
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Did the push-back driver push the aircraft at walking speed?
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Is 3-points disconnect process being followed?
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Did the marshaling agent wait until all equipment & personnel were clear of the aircraft's path to give the "All Clear" salute to the flight crew?
GENERAL BEHAVIOR
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Did agent drive at walking speed around aircraft?
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Were agents observed walking between connected conveyances or over towbar?
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Was there unsecured and or unattended equipment observed pointing at the aircraft?
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Provide GSE/Vehicle Number
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Were the curtains closed on all carts and cans?
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Were transporters and or carts observed with tongue down and not in locked position?
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Agent refrains from pushing GSE with GSE.
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Is agent using a seat belt while driving motorized equipment?
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Did tug driver have bags stacked on tug?
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Did driver keep extremities completely inside of the frame of the tug?
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Did driver ensure all personnel clear of conveyances before start pulling away from the gate?
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Is water hose retracted and capped?
MAKE-UP UNIT AREA
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Are 1st Cart or transporter on the MU staged with tongue in lock position?
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All GSEs not passing MU entrance or exit threshold?
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Are locks functional and secured on all transporters?
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Provide GSE number
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Are MUs and conveyances clear of FOD?
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Was agent(s) observed checking all conveyances for beyond limit damage?
EQUIPMENT OPERATED SAFETY
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Did driver have bags on tug?
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Are conveyance curtains secure prior to departing MU?
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Did driver keep extremities completely inside of the frame of the tug?
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Did the driver ensure all personnel cleared conveyances before pulling away from the pier?
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Were there more than 4 Conveyances being hauled out of MU at a time?
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Did you observe driver exceed walking speed in and or around MU area?
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Did you observe the agent step over the tongue of the cart or transporter?
ERGONOMIC/OJI PREVENTION
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Did agent lift item with 2 hands and keep the load close to body while lifting?
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Was agent observed utilizing correct lifting techniques?
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Did agent asks for help to lift heavy bags?
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Did you observed agent(s) push/pull carts with elbows bent?
ADDITIONAL SAFETY CONCERN NEEDED TO BE REPORTED
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Do you have any additional safety or process concerns that need to be reported?
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Please describe your concern (s):