FMSO Running Over Small Vehicle

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

Running Over Small Vehicle - Fatality Prevention Audit

• test

  Yes

  No

  N/A

• Check random in-pit drivers for in-pit driving sticker compliance.

  Environmental

  Health (dust, noise)

  Improve Safety

  Positive Recognition

  Housekeeping

• Completion Date:

• Spot check and verify proper equipment passing procedures are being followed.

  Environmental

  Health (dust, noise)

  Improve Safety

  Positive Recognition

  Housekeeping

• Completion Date:

• Audit small vehicles for headlights on, company radio tuned to pit frequency and working buggy whips.

  Environmental

  Health (dust, noise)

  Improve Safety

  Positive Recognition

  Housekeeping

• Completion Date:

• Ensure support equipment vehicles are parked clear of work area.

  Environmental

  Health (dust, noise)

  Improve Safety

  Positive Recognition

  Housekeeping

• Completion Date:

• Auditor(s) Signature

  Sign

• Revision 1.0 iCloud posted document is the controlled copy. 06/18/13