Crew Visit Inspection

• Conducted on

  Date

• Document No.

• Audit Title

• Client / Site

• Prepared by

• Personnel

• Location
  Address

Job Description Being Performed

JOB PLANNING

• Job Briefing?

  Yes

  No

  N/A

• Documented?

  Yes

  No

  N/A

• Discussion on site?

  Yes

  No

  N/A

• Comments:

PERSONAL PROTECTIVE EQUIPMENT

• Is eye protection being worn?

  Yes

  No

  N/A

• Are hard hats used according to Safety Manual requirements?

  Yes

  No

  N/A

• Is hand protection being used?

  Yes

  No

  N/A

• Is foot ware appropriate to job?

  Yes

  No

  N/A

• Is hearing protection used when needed?

  Yes

  No

  N/A

• Is clothing policy followed?

  Yes

  No

  N/A

• Comments:

VEHICLES

• Are wheel chocks used?

  Yes

  No

  N/A

• Daily pre-trip inspection performed?

  Yes

  No

  N/A

• Did they "fly" the booms?

  Yes

  No

  N/A

• Diggers/buckets properly set up?

  Yes

  No

  N/A

• Vehicles grounded?

  Yes

  No

  N/A

• Comments:

OVERHEAD AND URD CONSTRUCTION

• All equipment inspected prior to use?

  Yes

  No

  N/A

• All equipment used correctly?

  Yes

  No

  N/A

• Working between grounds?

  Yes

  No

  N/A

• Are grounds in good condition and tested?

  Yes

  No

  N/A

• Are hand lines used?

  Yes

  No

  N/A

• Is there good housekeeping?

  Yes

  No

  N/A

• Are excavations safe?

  Yes

  No

  N/A

• Comments:

ENERGIZED WORK

• Are sleeves and gloves correct rating and date?

  Yes

  No

  N/A

• Are gloves air tested and inspected prior to use?

  Yes

  No

  N/A

• Is adequate cover-up used?

  Yes

  No

  N/A

• Are approach distances maintained?

  Yes

  No

  N/A

• Is ground-ground, lock-lock policy followed?

  Yes

  No

  N/A

• Are employees performing hot work observed?

  Yes

  No

  N/A

• Comments:

GENERAL

• Are poles tested prior to climbing?

  Yes

  No

  N/A

• Is proper fall protection in used?

  Yes

  No

  N/A

• Is climbing equipment inspected before use?

  Yes

  No

  N/A

• Are gaff guards used?

  Yes

  No

  N/A

• Are slings in good shape?

  Yes

  No

  N/A

• Is work area clean when job is finished?

  Yes

  No

  N/A

• Comments:

TRAFFIC CONTROL

• Are beacon/strobe lights used?

  Yes

  No

  N/A

• Are four way flashers used?

  Yes

  No

  N/A

• Are reflective vests used?

  Yes

  No

  N/A

• Were cones used?

  Yes

  No

  N/A

• Were signs used?

  Yes

  No

  N/A

• Was law enforcement used?

  Yes

  No

  N/A

• Was a flagger used?

  Yes

  No

  N/A

• Comments:

REVIEWED

• Department Head:

  Sign

• Take photos of the job site or use from gallery.

  Media