CT Site/Vehicle/Task Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Driver Information

• Name:

• Truck Number

• Pre-Trip Performed:

  Yes

  No

  N/A

• Client SOP Knowledge:

  Yes

  No

  N/A

Qualifications

• Driver has a valid license for the vehicle

  Yes

  No

  N/A

• Driver has Journey Management Directions

  Yes

  No

  N/A

• A JSA is prepared for the task

  Yes

  No

  N/A

Personal Protective Equipment

• Hard hat and hearing protection

  Compliant

  Non-Compliant

  N/A

• Safety glasses with side shields

  Compliant

  Non-Compliant

  N/A

• Boots with steel/composite toe protection

  Compliant

  Non-Compliant

  N/A

• Impact resistant gloves

  Compliant

  Non-Compliant

  N/A

• FR clothing - No Hoodies

  Compliant

  Non-Compliant

  N/A

• Boot traction devices (when required)

  Compliant

  Non-Compliant

  N/A

• Reflective FR vest

  Compliant

  Non-Compliant

  N/A

Vehicle Safety Equipment

• Warning triangles and cones

  Compliant

  Non-Compliant

  N/A

• Securely mounted fire extinguisher

  Compliant

  Non-Compliant

  N/A

• First aid kit present and stocked

  Compliant

  Non-Compliant

  N/A

• Tire chains present and serviceable

  Compliant

  Non-Compliant

  N/A

Vehicle Condition

• Items and equipment secured in cab

  Compliant

  Non-Compliant

  N/A

• Vehicle can clean and organized

  Compliant

  Non-Compliant

  N/A

• Vehicle has no fluid leaks

  Compliant

  Non-Compliant

  N/A

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

  Compliant

  Non-Compliant

  N/A

• Light devices are in working order

  Compliant

  Non-Compliant

  N/A

• Equipment for transfer is secured

  Compliant

  Non-Compliant

  N/A

Arrival, Staging, Loading, and Unloading

• Seatbelt in use when vehicle is in motion

  Compliant

  Non-Compliant

  N/A

• Cell phone policy is observed

  Compliant

  Non-Compliant

  N/A

• Sure speed limit is observed

  Compliant

  Non-Compliant

  N/A

• Driver utilizes chocks

  Compliant

  Non-Compliant

  N/A

• Spotter or GOAL is utilized during backing procedures

  Compliant

  Non-Compliant

  N/A

• Driver in final position before loading or unloading

  Compliant

  Non-Compliant

  N/A

• Duck ponds in place under connections

  Compliant

  Non-Compliant

  N/A

• Check in with site supervisor when required

  Compliant

  Non-Compliant

  N/A

• Placed buckets/pans as needed, attached ground cable

  Compliant

  Non-Compliant

  N/A

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

  Compliant

  Non-Compliant

  N/A

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

  Compliant

  Non-Compliant

  N/A

• Open valves at the manifold first, then the vehicle

  Compliant

  Non-Compliant

  N/A

• Vacuum the hose dry using the bleeder valve

  Compliant

  Non-Compliant

  N/A

• Ensure bleeder valves are closed

  Compliant

  Non-Compliant

  N/A

• Disconnect hose, caps and plugs are secured

  Compliant

  Non-Compliant

  N/A

• Driver stays behind the vehicle during fluid transfer

  Compliant

  Non-Compliant

  N/A

• Stores and secures equipment for transfer

  Compliant

  Non-Compliant

  N/A

• Drip pans are vacuumed out

  Compliant

  Non-Compliant

  N/A

• Driver shuts down PTO per SOP

  Compliant

  Non-Compliant

  N/A

• Performs a 360 walk around inspection

  Compliant

  Non-Compliant

  N/A

• Paperwork signed by responsible party (if needed)

  Compliant

  Non-Compliant

  N/A

• Waits for spotter/pusher to release driver

  Compliant

  Non-Compliant

  N/A

• Safely exits site

  Compliant

  Non-Compliant

  N/A

Pump and Gauge Operation

• Pump operation knowledge

  Compliant

  Non-Compliant

  N/A

• Engages PTO per SOP

  Compliant

  Non-Compliant

  N/A

• Gauge accuracy

  Compliant

  Non-Compliant

  N/A

• Periodically checks pump for oil or water leajs

  Compliant

  Non-Compliant

  N/A

Comments:

• Deficiencies:

Inspector Signature

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