Information
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Document No.
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Audit Title
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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
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Workgroup
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Function
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Business Unit
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Number of Employees
General
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1. Do they perform their circle for safety
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Section 7.11 Fleet Manual
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2. Broken (non-working) lights-inspect and repair any lights not working
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3, Worn/Flat tires-inspect and replace tires as needed
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Valve Stem Covers in place?
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4. Bad Wipers-Replace worn blades
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5. Cracked Windshield-Inspect and replace as needed
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6. Unsecured load-inspect and adjust-tie all material down
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7. Obstructions-look around for hazards. Clean windows and mirrors
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Backing reference: Section 7.12 Flee Management Manual
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8. Slipping or falling-Use 3 points of contact for entering and leaving vehicle
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Section 7.4 Fleet Management Manual
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9. Did the vehicle pass inspection today (no broken items or defects)?
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Section 7.8 Fleet Management Manual
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10. Complete DOT pre-trip checklist and associated forms for all DOT vehicles and trailers
Smith Driving
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11. Did the employee use the information from Smith Driving (5 keys)?
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12. Aim high in steering
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Looking at the horizon
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13. Get the big picture
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14. Keep your eyes moving
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360 degrees of vision
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15. Leave yourself an out
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16. Make sure they see you
General Continued
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17. Yielded appropriately in traffic as well as with pedestrians
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18. Are they scanning their mirrors
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19. Are the mirrors properly aligned
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20. How is their following distance
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21. When stopping at a red light are they leaving space in front of them (length of their vehicle)
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Can they see the tires of the vehicle in front of them?
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22. Are they properly parking the vehicle (with traffic, using cones, etc.)
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In accordance with MUTCD applications section 6
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23. Seatbelts always in use
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Section 15.2 (1) of T&D Safety Manual
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24. Utilized a hands free device
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25. Kept vehicle in center of lane
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26. Minimized lane changes
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27. Turned from/into proper lane
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28. Remained focused on driving (not eating, moving paperwork, mobile data unit closed, etc.)
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29. Proper use of turn signals
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30. Turned on headlights
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31. Used flashers when appropriate
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32. Traveled at or below posted speed limits (dictated by weather/road conditions)
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33. Traffic/Construction-Avoid areas of known construction if possible, use alternate route if needed
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34. Avoided backing whenever possible
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Section 7.11 Fleet Manual
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35. Used a spotter when backing was necessary
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Section 7.12 Fleet Manual
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36. Removed key when parked
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Section 7.14 Fleet Manual
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37. Complete DOT post-trip checklist and any associated forms for all DOT vehicles and trailers
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Comments
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Additional Comments
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Signature