Driver Safety Field Observation

Audit

Driver Information

Driver name

Truck number

Trailer

Select date

Was driver present at time of inspection

Vehicle observations
Type of location observation made
Condition of vehicle interior

Notes on interior

Image of cab interior
Condition of vehicle exterior
Image of exterior
Image of any damage to exterior
Fuel delivery equipment

Fuel drop hoses servicable

Loading head caps and plugs safe and secured properly

Fuel drops in serviceable condition

Number of internal vapor drops
Number of standard drops
Number of vapor return fittings
Image of defective equipment
Fuel delivery safety observations

Driver using proper PPE

Safety cones in use protecting work area

Driver was at loading/drop heads while in use

Noticeable leakage from fittings, drops, hoses

Driving observations

Vehicle operated in generally safe manner

Unsafe actions observed
Unsafe actions observed
Unsafe actions observed
Unsafe actions observed
Unsafe actions observed

Notes on driving observations

General notes and comments on review

Notes and comments

Driver signature
Observer signature

Driver Safety Field Observation Checklist

Fuel transport safety observation

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Audit

Driver Information

Driver name

Truck number

Trailer

Select date

Was driver present at time of inspection

Vehicle observations
Type of location observation made
Condition of vehicle interior

Notes on interior

Image of cab interior
Condition of vehicle exterior
Image of exterior
Image of any damage to exterior
Fuel delivery equipment

Fuel drop hoses servicable

Loading head caps and plugs safe and secured properly

Fuel drops in serviceable condition

Number of internal vapor drops
Number of standard drops
Number of vapor return fittings
Image of defective equipment
Fuel delivery safety observations

Driver using proper PPE

Safety cones in use protecting work area

Driver was at loading/drop heads while in use

Noticeable leakage from fittings, drops, hoses

Driving observations

Vehicle operated in generally safe manner

Unsafe actions observed
Unsafe actions observed
Unsafe actions observed
Unsafe actions observed
Unsafe actions observed

Notes on driving observations

General notes and comments on review

Notes and comments

Driver signature
Observer signature