Title Page

  • Site conducted

  • Date of Drill

  • Prepared by

  • Time of Emergency Notification

  • Departments Effected

  • Shift

Evaluation Area Headcount

Growing

  • # of watering/disease on site

  • # of watering/disease present

  • # of night watchmen on site

  • # of night watchmen present

  • # of crew on site

  • # of crew present

  • # of prep on site

  • # of prep present

Harvest

  • # of harvesters on site

  • # of harvesters present

  • # of scanners/tuggers on site

  • # of scanners/tuggers present

Shipping and Distribution

  • # of shipper/receiving on site

  • # of shipper/receiving present

  • # of drivers on site

  • # of drivers present

Maintenance

  • # of maintenance on site

  • # of maintenance present

Wharf and Tunnels

  • # of tunnels on site

  • # of tunnels present

  • # of wharf on site

  • # of wharf present

Quality

  • # of runners/qct on site

  • # of runners/qct present

  • # of housekeeping on site

  • # of housekeeping present

Packing

  • # of packing on site

  • # of packing present

Managers/Office Staff

  • # of mgt/office on site

  • # of mgt/office present

Non-Highline Persons

  • # of visitors on site

  • # of visitors present

Assesment

  • Who were the persons in charge at the meeting area?

  • Was anyone unaccounted for?

  • What was done to account for the missing person?

  • What comments/concerns were noted:

  • What suggestions were made for improvements?

  • Comments:

Sign Off

  • Evaluator

  • JHSC Member

  • Farm 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.