Title Page

  • Conducted on

  • Prepared by

Description of Operation

  • Specific Location:

  • Description of Operation:

  • As necessary, include a sketch or diagram showing the planned sUAS flight path or area of operations. Sketch should include home point, observation points, applicable right of ways and property lines, and known hazards.

  • Attachments:

Explain Risk Mitigation measures for all Medium (yellow) and High (red) risks.

  • Complexity of Mission:

  • DOC experience with mission type:

  • Controlled Airspace:

  • Private Property:

  • Daylight:

  • Wires/Trees/Structures:

  • Drone Distance from Operator:

  • Proximity to Roads:

  • Proximity to Radio Towers:

  • Nearby Airport/Heliport:

  • Pedestrians/distraction:

  • Over Water:

  • GPS/Radio Dead Spots:

Overall Site Risk Rating

  • Fill in highest rating from the above inspection:

Signature

  • Drone Manager:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.