Information
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Conducted on
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Observed By
- Benjamin Rhode
- Mike Murray
- Tom Wolfenbarger
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Location
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In Charge
- Daniel Chaney
- Rhett Hughes
- Randy Kirkpatrick
- Frank Young
- Denis Armstead
- Bob McIntosh
- Jeff McGraw
- Bruce Clark
- Bill Humbert
- Randy Hudson
- Scott Alvey
- Rodney Taylor
- Curt Lowenstine
- Derk Beckett
- Jesse Moreland
- Kevin Maddock
- Jeremy Hill
- Ray Brunner
- Larry Hournung
- Steve Fritche
- Bob Conrad
- Mick Johnson
- Mike Sherman
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Personnel
- Daniel Chaney
- Rhett Hughes
- Randy Kirkpatrick
- Frank Young
- Denis Armstead
- Bob McIntosh
- Jeff McGraw
- Bruce Clark
- Bill Humbert
- Randy Hudson
- Scott Alvey
- Rodney Taylor
- Curt Lowenstine
- Derk Beckett
- Jesse Moreland
- Kevin Maddock
- Jeremy Hill
- Ray Brunner
- Larry Hournung
- Steve Fritche
- Bob Conrad
- Mick Johnson
- Mike Sherman
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Weather
- Sunny
- Cloudy
- Partly Cloudy
- Rain
- Snow
- Ice
- Hot
- Cold
- Warm
- Cool
- Foggy
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Temperature
- 0
- 10's
- 20's
- 30's
- 40's
- 50's
- 60's
- 70's
- 80's
- 90's
- 100's
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Line Type
- Overhead
- Underground
- De-energized
- De-energized(Grounded)
- Distribution
- Transmission
- Secondary
- None
- Energized
- Low Voltage(less Than 600V)
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Large Equipment On Site
- 11
- 12
- 16
- 20
- 23
- 25
- 26
- 28
- 30
- 31
- 32
- 37
- 40
- 44
- 45
- 48
- 50
- 51
- 52
- 55
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Location Type
- Field
- State Route
- County Road
- Township Road
- Member's property
- Non-paved
- Sub Station
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Type of Inspection
- Regular Working Hours
- After Hours
- Outage
- Emergency
- Storm Restoration
PPE
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Hard Hat?
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Fall Protection
- Needed
- Not Wearing harness
- Pre Use inpection
- Proper Use
- Not Needed
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Is the correct clothing being worn?
- Yes
- No
- FR
- Clean
- Torn or Soiled
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Hearing Protection?
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Hand Protection?
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Safety Glasses?
Job Preparation
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Job Briefing Documented?
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OCR in one shot?
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Open Switch?
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Line Switched
Grounding
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Are the Trucks Grounded?
- Yes
- No
- System Neutral
- Pole Ground
- Barricaded
- N/A
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Equalpotential Grounding?
Cover Up
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Cover Up Used?
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Adequate cover up?
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Pre use inspection?
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Proper Storage?
Traffic Control
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Traffic Vests are being worn?
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Traffic Vest Condition
- Bright
- Still Reflective
- N/A
- Needs replaced
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Plenty of Cones
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Traffic Flaggers
- Yes
- N/A
- No
- Employee
- Contract
Poles/ Wires
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Pole Inspected
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Wires Inspected?
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Adjacent Spans Inspected?
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Adjacent Poles Inspected
Ladders
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Inspected Before Use?
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Proper Ladder being used?
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Ladders is set up properly?
Equipment
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First Aid Kit
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Outrigger Pads
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Wheel Chocks
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AED
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Add media
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Observed
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Person in Charge