Driver Safety Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Information

• Driver Name:

• Project Name:

• Project Location:
  Address

• Vehicle Type:

• Safety Coordinator:

  Sign

• Date and Time:

  Date

Truck Supplies

• Are First Aid Kits Accessible and Identified?

  Yes

  No

  N/A

• Is the fire extinguisher current and in good condition?

  Yes

  No

  N/A

• Does the driver know the location of the fire extinguisher?

  Yes

  No

  N/A

• Are there 3 reflective triangles in the vehicle?

  Yes

  No

  N/A

• Are proper receptacles available for storage of flammables?

  Yes

  No

  N/A

• Does vehicle have an accident report packet?

  Yes

  No

  N/A

Inspection:

• Has a vehicle inspection been performed?

  Yes

  No

  N/A

• Is the vehicle clean and neat in appearance?

  Yes

  No

  N/A

• Do seat belts work properly?

  Yes

  No

  N/A

• Are the tires in good condition?

  Yes

  No

  N/A

• Do all lights / signals work properly?

  Yes

  No

  N/A

• Are all mirrors in place?

  Yes

  No

  N/A

• Is the vehicle in good physical working condition?

  Yes

  No

  N/A

• Are back up alarms installed and working on equipment?

  Yes

  No

  N/A

• Are guards and safety appliances in place and used?

  Yes

  No

  N/A

• Are the tags up to date?

  Yes

  No

  N/A

• Is a pre-trip inspection done on regulated vehicles?

  Yes

  No

  N/A

Emergency Plans

• Are emergency telephone numbers posted?

  Yes

  No

  N/A

• Have emergency escape routes been designated?

  Yes

  No

  N/A

• Are employees familiar with the emergency signal?

  Yes

  No

  N/A

• Does dispatcher know driver's daily schedule?

  Yes

  No

  N/A

Site Safety Plan

• Is a site safety plan posted on site or accessible to all employees?

  Yes

  No

  N/A

• Have potential hazards been described to employees on site?

  Yes

  No

  N/A

• Are material safety data sheets available for review?

  Yes

  No

  N/A

Material Handling

• Are materials stacked and stored as to prevent sliding or collapsing?

  Yes

  No

  N/A

• Are flammables and combustibles stored in non-smoking areas?

  Yes

  No

  N/A

• Are cranes inspected as prescribed and logged?

  Yes

  No

  N/A

• Are all containers labeled as to contents?

  Yes

  No

  N/A

• Are flammable liquids stored in approved safety cans?

  Yes

  No

  N/A

• Does driver use lift gate or ramp to load material?

  Yes

  No

  N/A

• Are straps in good condition?

  Yes

  No

  N/A

• Is the load strapped and secure?

  Yes

  No

  N/A

• Is pipe strapped at a minimum of 8' intervals?

  Yes

  No

  N/A

• Are compressed gas cylinders properly capped, secured, and upright?

  Yes

  No

  N/A

Driving

• Does driver obey all traffic laws?

  Yes

  No

  N/A

• Does driver maintain proper steering control?

  Yes

  No

  N/A

• Does driver use signals?

  Yes

  No

  N/A

• Does driver stay focused on the road at all times?

  Yes

  No

  N/A

• Does driver check blind spots before merging?

  Yes

  No

  N/A

• Does driver use spotter when backing a trailer?

  Yes

  No

  N/A

• Does driver maintain proper braking distance?

  Yes

  No

  N/A

• Does driver grind gears if vehicle is a standard?

  Yes

  No

  N/A

• Does driver maintain log book for regulated vehicles?

  Yes

  No

  N/A

On Site

• Does driver contact the Brandt job-site personnel upon arriving on site?

  Yes

  No

  N/A

• Does driver follow instruction upon arriving on site?

  Yes

  No

  N/A

• Does driver keep clear of suspended loads?

  Yes

  No

  N/A

• Does driver touch pre-fab without giving instruction?

  Yes

  No

  N/A

• Is lift gate used to unload material?

  Yes

  No

  N/A

• Has a good means of communication been established?

  Yes

  No

  N/A

• Is driver aware of surroundings on site?

  Yes

  No

  N/A

• Does driver give pedestrians the right away?

  Yes

  No

  N/A

• Is the driver's log signed before leaving?

  Yes

  No

  N/A

• Are extra straps and ratchets stored away before leaving?

  Yes

  No

  N/A

• Is trailer and lift gate in place before leaving?

  Yes

  No

  N/A

Task Hazard Analysis

• Is a THA filled out for the project?

  Yes

  No

  N/A

• Is the THA filled out correctly?

  Yes

  No

  N/A

• Has the driver's log been signed by deliverer and receiver?

  Yes

  No

  N/A

Lift Inspection

• Has lift inspection been performed?

  Yes

  No

  N/A

• Is lift clean and in good working order?

  Yes

  No

  N/A

Signatures

• Driver:

  Sign

• Supervisor:

  Sign

• Safety Coordinator:

  Sign