Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Driver Information

  • Name:

  • Truck Number

  • Pre-Trip Performed:

  • Client SOP Knowledge:


  • Driver has a valid license for the vehicle

  • Driver has Journey Management Directions

  • A JSA is prepared for the task

Personal Protective Equipment

  • Hard hat and hearing protection

  • Safety glasses with side shields

  • Boots with steel/composite toe protection

  • Impact resistant gloves

  • FR clothing - No Hoodies

  • Boot traction devices (when required)

  • Reflective FR vest

Vehicle Safety Equipment

  • Warning triangles and cones

  • Securely mounted fire extinguisher

  • First aid kit present and stocked

  • Tire chains present and serviceable

Vehicle Condition

  • Items and equipment secured in cab

  • Vehicle can clean and organized

  • Vehicle has no fluid leaks

  • Tires are within acceptable DOT standards (no balding, body ply/belt material exposed)

  • Light devices are in working order

  • Equipment for transfer is secured

Arrival, Staging, Loading, and Unloading

  • Seatbelt in use when vehicle is in motion

  • Cell phone policy is observed

  • Sure speed limit is observed

  • Driver utilizes chocks

  • Spotter or GOAL is utilized during backing procedures

  • Driver in final position before loading or unloading

  • Duck ponds in place under connections

  • Check in with site supervisor when required

  • Placed buckets/pans as needed, attached ground cable

  • Inspect, connect the hose, and install cam lock safety devices

  • Ensure bleeder valves are closed at the vehicle and the manifold

  • Open valves at the manifold first, then the vehicle

  • Vacuum the hose dry using the bleeder valve

  • Ensure bleeder valves are closed

  • Disconnect hose, caps and plugs are secured

  • Driver stays behind the vehicle during fluid transfer

  • Stores and secures equipment for transfer

  • Drip pans are vacuumed out

  • Driver shuts down PTO per SOP

  • Performs a 360 walk around inspection

  • Paperwork signed by responsible party (if needed)

  • Waits for spotter/pusher to release driver

  • Safely exits site

Pump and Gauge Operation

  • Pump operation knowledge

  • Engages PTO per SOP

  • Gauge accuracy

  • Periodically checks pump for oil or water leajs


  • Deficiencies:

Inspector Signature

  • Add signature

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