Title Page

  • Conducted on

  • Audit Completed By:

  • Location

Audit Info

  • Driver Name:

  • District

Driver

  • <br>Gas Monitor properly worn

  • Safety Glasses

  • Uniform (FR)

  • Hand Protection (gloves)

  • Steel Toe Boots

  • Hard Hat

  • <br>CDL (current, on person)

  • HM Endorsement is current

  • H2S (is current and is on person)

  • <br>MEC (current, on person)

  • <br>In attendance (loading/unloading)

Vehicle

  • Truck Unit Number

  • Trailer Unit Number

  • DOT Annual Inspections are current (truck and semi trailer)

  • Wheel Chocks set/ cones properly placed

  • Grounding cable is properly attached

  • <br>Tire condition acceptable

  • <br>Lights properly working

  • emergency equipment ( fire extinguisher, triangles, spare fuses)

  • <br>Permit book (IRP, IFTA, HM permit, Insurance card, over axle/gross permit,

  • Any other defects noted?

  • List any other noted defects

  • Add media

  • Proper Placarding - (clean, visible, properly attached, not obstructed and not worn)

  • <br>Cargo tank inspections current

  • Equipment is free of leaking cargo

Observed Driving Behaviors

  • Seatbelt in use

  • General Driving Behavior

  • Describe observed behavior and what coaching occurred.

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