Page 1: Initial questions
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Date and Time
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Prepared by
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Location
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Driver Name
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Unit Number
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Terminal
Page 2: Main checklist
PPE Check
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Safety Glasses
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Hard Hat
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Gloves
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Proper Footwear
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FR Clothing
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H2S Monitor
Truck Safety Equipment Check
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Fire Extinguisher
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Reflective Triangles
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Spare Fuses
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Loading Audit
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Verified Correct Location
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Truck Properly Positioned
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Unit Grounded
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Wheels are Chocked
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Cones/Fire Extinguisher Out
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All Required PPE's Being Used
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Verified Tank Levels
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Proper Lifting Techniques Used
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Hose Connections Checked (No Dripping or Leaking)
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Bucket Used Properly
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Vent Hose Connected
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Crude Oil Properly Tested
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Monitored Trailer During Loading
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Unloading Audit
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Verified Correct Location
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Truck Properly Positioned
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Unit Grounded
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Wheels are Chocked
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Cones/Fire Extinguisher Out
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All Required PPE's Being Used
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Tank Levels Verified
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Proper Lifting Techniques Used
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Hose Connections Checked (No Dripping or Leaking)
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Bucket Used Properly
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Monitored Trailer During Unloading
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Vehicle Audit
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No Visible Damage to Truck or Trailer (Picture Required If Found Damage)
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Unit Clean
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Windows and Mirrors in Good Shape
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All Lights Working Properly
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Truck and Trailer Inspections Up To Date
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Truck Door Decal in Good Shape (Company Name W/ LLC, DOT# 2186770, Truck Number)
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Trailer Decal in Good Shape (Side And Back)
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Emergency Shutoff Decal in Good Shape
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Placards in Good Shape
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DOT Tape in Good Shape
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Stops At All Railroad Crossing Decal in Good Shape
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No Obvious Air Leaks
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5th Wheel and Landing Gear In Good Shape
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Tire, Hubs, and Lug Nuts in Good Shape
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Hoses and Fittings in Good Shape
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Spill Kit in Good Shape
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Cab Book in Good Shape
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Inside of Cab Clean
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Driving Audit
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Maintains Lane
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Follows Posted Speed Limits/Speeds Appropriate for Roads
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Good Following Distance
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Seat Belt Visible
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Avoids Distractions
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Brakes and/or Slows Gradually
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Makes Complete Stops at Lights and/or Stop Signs
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Stops at all Railroad Crossings
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Accelerates Gradually
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Audit Notes, Improvements Needed, Actions to be Taken
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