• Drive up photos.

General

  • Name of person in charge

  • Names of Crew Members

  • Type of work being performed?

  • Was a written job briefing/tailgate conducted?

  • Photo of tailgate.

Location

  • Address of job site?

  • Name of Substation

  • Feeder

  • Breaker, Breaker Set, Fuse

  • Is one shot or HTL installed?

  • Is line Energized?

  • Is line grounded?

PPE

  • Hi Vis Arc Rated/FR Apparel

  • Head Protection

  • Hearing Protection

  • Eye Protection

  • Face Protection

  • Hand Protection

  • Foot Protection

  • Fall Protection

  • Personal Grounds

  • Rubber Gloves

  • Rubber Sleeves

  • Other PPE used or needed.

  • Is all required PPE in use?

  • PPE comment.

Proper Tool and Equipment Use

  • Vehicle Grounds

  • Shoring Equipment

  • Hotline Tools

  • Wire Cutters

  • Voltage Indicators

  • Roller Grounds

  • Elbow Grounds

  • Spiking Tools

  • Cover Up Material

  • Tagging Devices

  • Tag Lines

  • Proper Clearences

  • Crimping Tools

  • Truck Jibs

  • Other equipment used or needed.

  • Are proper tools and equipment in use, as job requires?

  • Tools and equipment comments?

Traffic Control Devices

  • Truck Flashers Operating

  • Truck Beacons Operating

  • Traffic Cones in Place

  • Traffic Signs Installed and Visible

  • Barricades are being utilized?

  • Traffic Flaggers are being utilized?

  • Other equipment used or needed.

  • Are the necessary traffic control devices being used?

  • Traffic Control Comments

RESAP

  • Fire Extinguisher in date with inspection and tagged?

  • First Aid Kit has no expired items?

  • Dielectric test on trucks and booms within test date?

  • DOT truck inspections completed and in date?

  • All report forms present

Comments/Action Needed

  • Observer Comments

  • Corrective action that needs to be taken.

  • Date corrective action taken or instruction given.

Signatures

  • Designated Person in Charge

  • Observer

  • Operations and Safety Coordinator

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