Title Page
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Conducted on
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Audit Completed By:
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Location
Audit Info
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Driver Name:
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District
- Nitrogen
- Monahans
- Kermit
- Orla
- Stockdale
- Charlotte
- Crude Long Haul
Driver
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<br>Gas Monitor properly worn
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Safety Glasses
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Uniform (FR)
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Hand Protection (gloves)
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Steel Toe Boots
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Hard Hat
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<br>CDL (current, on person)
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HM Endorsement is current
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H2S (is current and is on person)
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<br>MEC (current, on person)
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<br>In attendance (loading/unloading)
Vehicle
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Truck Unit Number
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Trailer Unit Number
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DOT Annual Inspections are current (truck and semi trailer)
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Wheel Chocks set/ cones properly placed
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Grounding cable is properly attached
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<br>Tire condition acceptable
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<br>Lights properly working
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emergency equipment ( fire extinguisher, triangles, spare fuses)
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<br>Permit book (IRP, IFTA, HM permit, Insurance card, over axle/gross permit,
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Any other defects noted?
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List any other noted defects
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Add media
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Proper Placarding - (clean, visible, properly attached, not obstructed and not worn)
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<br>Cargo tank inspections current
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Equipment is free of leaking cargo
Observed Driving Behaviors
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Seatbelt in use
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General Driving Behavior
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Describe observed behavior and what coaching occurred.