Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Vehicle
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Vehicle appearance inside and out
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Vehicle lighting
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Condition of Windshield/Glass/Mirrors
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Tires
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Cones/Placement
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Horn/Wipers/Guages
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Strobes and Flashers
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Truck sticker in place and in good condition
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Truck Mileage
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Oil Change Current
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Location and condition of fuel card
Personal Protective Equipment (PPE)
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Mixing and Spray Gloves
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Safety Glasses
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Hard Hat
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Long sleeve shirt
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Hearing Protection
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Respirator
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Safety Vest
Documentation
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Vehicle Paperwork
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MSDS available and current
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DOT CDL Paperwork
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DOT Vehicle Paperwork
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JSA
Other Safety Items
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Fire Extinguisher inspected and working
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Spill Kit
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First Aid Kit available and fully stocked
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Eye wash bottle
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Drinking Water
Equipment
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Backpack/Probe condition
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Fuel Cans/Tanks
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Hoses/Clamps
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Chemicals labeled
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Nurse Tank Condition
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Skid Unit/Load Securement
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Straps/Chains
Employee
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Employee Appearance
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Employee I.D.
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Task Knowledge
Aquatic
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Boat condition
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Life vests in good condition and in use
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Rope
Comments
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Observation of good practices
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Areas where improvement is needed
Items Dispersed
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Equipment
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Number of gift cards dispersed
Employee Signatures
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Employee Signature
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Employee Signature
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Employee Signature