Fishel JSI - 2 Trucks/Trailers

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Paperwork

• DFR-Daily Utility Locating Inspection Checklist

  Yes

  No

  N/A

• Locate Tickets

  Yes

  No

  N/A

• Job Prints

  Yes

  No

  N/A

• Radio/Telephone

  Yes

  No

  N/A

• Job-Briefing

  Yes

  No

  N/A

Traffic Control

• Police

  Yes

  No

  N/A

• Certified Flaggers

  Yes

  No

  N/A

• Signs

  Yes

  No

  N/A

• Traffic Cones

  Yes

  No

  N/A

• Barricades

  Yes

  No

  N/A

• Arrow Board

  Yes

  No

  N/A

• Street Plates Secured

  Yes

  No

  N/A

• Sidewalks Protected

  Yes

  No

  N/A

• Crash Truck

  Yes

  No

  N/A

PPE

• Hard Hats

  Yes

  No

  N/A

• Proper Work Boots

  Yes

  No

  N/A

• Reflective Vests

  Yes

  No

  N/A

• Eye Protection

  Yes

  No

  N/A

• Ear Protection

  Yes

  No

  N/A

• Hand Protection/Gloves

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

Excavation Safety

• Excavation Inspection Report

  Yes

  No

  N/A

• Potholing at Proper Distance

  Yes

  No

  N/A

• Jacks and Sheeting

  Yes

  No

  N/A

• Trench Boxes/Tabulated Data

  Yes

  No

  N/A

• Sloped/Benched

  Yes

  No

  N/A

• Egress @4' and deeper

  Yes

  No

  N/A

• Spoils/Materials/Tools-2' from edge

  Yes

  No

  N/A

• Nearby Structures Protected

  Yes

  No

  N/A

• Walkway over 6" by 30"

  Yes

  No

  N/A

• Water Pump/Water Control

  Yes

  No

  N/A

• Snow Fence

  Yes

  No

  N/A

• Shoring at 5" and Deeper

  Yes

  No

  N/A

• General House keeping

  Yes

  No

  N/A

• Proper Locate Procedures

  Yes

  No

  N/A

• Proper Ladder Safety

  Yes

  No

  N/A

Fall Protection

• PFAS in Proper Use

  Yes

  No

  N/A

• Alternate Fall Protection

  Yes

  No

  N/A

• Proper Anchor Points

  Yes

  No

  N/A

• Fall Hazard Analysis

  Yes

  No

  N/A

• Inspection Completed

  Yes

  No

  N/A

Welding & Gas Work

• Proper PPE

  Yes

  No

  N/A

• Ventilation

  Yes

  No

  N/A

• Fire Watch/Extinguisher

  Yes

  No

  N/A

• Gauges & Hoses Checked

  Yes

  No

  N/A

• Work Properly shielded

  Yes

  No

  N/A

• Non-Sparking Hand Tools

  Yes

  No

  N/A

• Tools Properly Grounded

  Yes

  No

  N/A

• Holes are safe for Quick Escape

  Yes

  No

  N/A

Confined Space Entry

• Confined Space Entry Report

  Yes

  No

  N/A

• Authorized Teammates

  Yes

  No

  N/A

• Manhole Blower

  Yes

  No

  N/A

• Manhole Gaurd

  Yes

  No

  N/A

• Ladder-Secured with 3 ft. extension

  Yes

  No

  N/A

• Traffic Control

  Yes

  No

  N/A

• Water Pump/Water Control

  Yes

  No

  N/A

• Emergency Equipment

  Yes

  No

  N/A

Directional Drill

• Proper Grounding

  Yes

  No

  N/A

• Gloves Tested

  Yes

  No

  N/A

• Glove Bag

  Yes

  No

  N/A

• Dielectric Rubber Gloves/Leather Glove Protectors

  Yes

  No

  N/A

• Dielectric Boots-Operator

  Yes

  No

  N/A

• Dielectric Boots-Locator

  Yes

  No

  N/A

• Two-way Radios

  Yes

  No

  N/A

• Strike Alarm Installed & Checked

  Yes

  No

  N/A

• Calibrate Drill Head

  Yes

  No

  N/A

• Safe Guard Equipment from Public

  Yes

  No

  N/A

Truck Inspection

• DVIR

  Yes

  No

  N/A

• DVIR

  Yes

  No

  N/A

• Water Cooler & Cups Secured

  Yes

  No

  N/A

• Water Cooler & Cups Secured

  Yes

  No

  N/A

• Service Exemption Letter

  Yes

  No

  N/A

• Service Exemption Letter

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Insurance Certificate & Vehicle Registration

  Yes

  No

  N/A

• Insurance Certificate & Vehicle Registration

  Yes

  No

  N/A

• MSDS Sticker

  Yes

  No

  N/A

• MSDS Sticker

  Yes

  No

  N/A

• IFTA License

  Yes

  No

  N/A

• IFTA License

  Yes

  No

  N/A

• Seat Belts

  Yes

  No

  N/A

• Seat Belts

  Yes

  No

  N/A

• Emergency Equipment

  Yes

  No

  N/A

• Emergency Equipment

  Yes

  No

  N/A

• License Plate (Date)

  Yes

  No

  N/A

• License Plate (Date)

  Yes

  No

  N/A

• Lights & Reflectors

  Yes

  No

  N/A

• Lights & Reflectors

  Yes

  No

  N/A

• Backup Alarm

  Yes

  No

  N/A

• Backup Alarm

  Yes

  No

  N/A

• Pintle Hooks & Safety Pins

  Yes

  No

  N/A

• Pintle Hooks & Safety Pins

  Yes

  No

  N/A

• Strobe Flasher Light

  Yes

  No

  N/A

• Strobe Flasher Light

  Yes

  No

  N/A

• External Fuel Tanks

  Yes

  No

  N/A

• External Fuel Tanks

  Yes

  No

  N/A

• Glad Hands/Covers

  Yes

  No

  N/A

• Glad Hands/Covers

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Cleanliness & Proper Signage

  Yes

  No

  N/A

• Cleanliness & Proper Signage

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Tires

  Yes

  No

  N/A

• Tires

  Yes

  No

  N/A

Crane & Lift Trucks

• Tire Pressure

  Yes

  No

  N/A

• Outrigger Setup

  Yes

  No

  N/A

• Weight/Load Chart

  Yes

  No

  N/A

• Proper Lift Setup

  Yes

  No

  N/A

• Warning, Danger, and Caution stickers in place

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Proper Boom Securement

  Yes

  No

  N/A

• Proper Rigging

  Yes

  No

  N/A

• Operators Manual

  Yes

  No

  N/A

• Current Crane Inspection

  Yes

  No

  N/A

Trailer

• Lights & Reflectors

  Yes

  No

  N/A

• Lights & Reflectors

  Yes

  No

  N/A

• Tires & brakes

  Yes

  No

  N/A

• Tires & brakes

  Yes

  No

  N/A

• License Plate & registration

  Yes

  No

  N/A

• License Plate & registration

  Yes

  No

  N/A

• Hitch & Landing Gear

  Yes

  No

  N/A

• Hitch & Landing Gear

  Yes

  No

  N/A

• Emergency Break Away Device

  Yes

  No

  N/A

• Emergency Break Away Device

  Yes

  No

  N/A

• Glad Hands/Hoeses/Electric Lines/ Tie-Down Connections

  Yes

  No

  N/A

• Glad Hands/Hoeses/Electric Lines/ Tie-Down Connections

  Yes

  No

  N/A

• Decking & D-Rings

  Yes

  No

  N/A

• Decking & D-Rings

  Yes

  No

  N/A

• Anti-Theft Devices

  Yes

  No

  N/A

• Anti-Theft Devices

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• DVIR

  Yes

  No

  N/A

• DVIR

  Yes

  No

  N/A

Load Securement

• Binders

  Yes

  No

  N/A

• Chains & Hooks

  Yes

  No

  N/A

• Straps

  Yes

  No

  N/A

• Cargo Nets/Traps

  Yes

  No

  N/A

• Ramps Secured

  Yes

  No

  N/A

• Proper # of Tie-Downs

  Yes

  No

  N/A

Hand Tools/Ladders

• Safety Devices In Place

  Yes

  No

  N/A

• No Mushroom Heads

  Yes

  No

  N/A

• Ladders in Good Condition

  Yes

  No

  N/A

• Round Point Shovel

  Yes

  No

  N/A

• Square Point Shovel

  Yes

  No

  N/A

• Sharpshooter Shovel

  Yes

  No

  N/A

Electrical Tools

• Electrical Tools in Good, Working Condition

  Yes

  No

  N/A

• Safety Devices in Place

  Yes

  No

  N/A

• Cords Checked for Damage

  Yes

  No

  N/A

• Proper PPE

  Yes

  No

  N/A

• GFCI

  Yes

  No

  N/A

• Parts Shielded

  Yes

  No

  N/A

Backhoe/Excavator

• Warning & Working Lights

  Yes

  No

  N/A

• Fluid Levels Checked

  Yes

  No

  N/A

• Seat Belt in Use

  Yes

  No

  N/A

• Windows & Glass

  Yes

  No

  N/A

• Operators Manual on Equipment

  Yes

  No

  N/A

• Teammates Clear of Red Zone

  Yes

  No

  N/A

• Backup Alarm & Horn

  Yes

  No

  N/A

Forklift Safety

• Pre-Work Inspection

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Seat Belt

  Yes

  No

  N/A

• Operators Manual

  Yes

  No

  N/A

• Trained Operator

  Yes

  No

  N/A

Lockout/Tagout

• Authorized Teammates

  Yes

  No

  N/A

• Lock & Tag in Place

  Yes

  No

  N/A

• Affected Teammates Notified

  Yes

  No

  N/A

• Company Safety Procedures Followed

  Yes

  No

  N/A

• Teammate Understands LOTO Responsibilities

  Yes

  No

  N/A

Chemicals/Others

• Hazardous Items Labeled

  Yes

  No

  N/A

• Proper Fuel Can

  Yes

  No

  N/A

• Lifting Devices Properly Labeled & in Working Order

  Yes

  No

  N/A

Air Compressors/Pneumatic Tools

• Pressure Reducing Valve

  Yes

  No

  N/A

• Hoses & Safety Clips

  Yes

  No

  N/A

• Jack Hammer Foot Protection

  Yes

  No

  N/A

• Pre-Work Inspection

  Yes

  No

  N/A

• Safety Devices

  Yes

  No

  N/A

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  Date