Driver Observation

• Conducted on

  Date

• Audit Completed By:

• Location
  Address

Audit Info

• Driver Name:

• District

  Select Owner Operator Permian Bakken Midcontinent Eagle Ford East Texas

  • Owner Operator
  • Permian
  • Bakken
  • Midcontinent
  • Eagle Ford
  • East Texas

Driver

• <br>Gas Monitor properly worn

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Uniform (FR)

  Yes

  No

  N/A

• Hand Protection (gloves)

  Yes

  No

  N/A

• Steel Toe Boots

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• <br>CDL (current, on person)

  Yes

  No

  N/A

• HM Endorsement is current

  Yes

  No

  N/A

• H2S (is current and is on person)

  Yes

  No

  N/A

• <br>MEC (current, on person)

  Yes

  No

  N/A

• <br>In attendance (loading/unloading)

  Yes

  No

  N/A

Vehicle

• Truck Unit Number

• Trailer Unit Number

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

  Yes

  No

  N/A

• Wheel Chocks set/ cones properly placed

  Yes

  No

  N/A

• Grounding cable is properly attached

  Yes

  No

  N/A

• <br>Tire condition acceptable

  Yes

  No

  N/A

• <br>Lights properly working

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Any other defects noted?

  No

  Yes

  N/A

• List any other noted defects

• Add media

  Media

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

  Yes

  No

  N/A

• <br>Cargo tank inspections current

  Yes

  No

  N/A

• Equipment is free of leaking cargo

  Yes

  No

  N/A

Observed Driving Behaviors

• Seatbelt in use

  Yes

  No

  N/A

• General Driving Behavior

  Safe

  Coached

  N/A

• Describe observed behavior and what coaching occurred.