Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

T&D Solutions Utility Safety Inspection 2016

  • Type of Inspection

  • Workgroup

  • Department number

  • Number of Employees

Observer Inspection

  • 1. Has the employee taken a defensive driving course?

  • 2. Did the Employee perform a pre-trip inspection and 360 walk-around?

  • 3. Are all loads properly secured and weight limits checked and observed?

  • 4. Did the employee plan the route to travel, if possible?

  • 5. Did the employee check seat and mirror adjustment?

  • 6. Did the employee fasten their seat belt before shifting into gear?

  • 7. Did the employee check the flow of traffic, give a signal, and wait for a suitable gap to merge into traffic?

  • 8. Does the employee use 2 hands while driving and maintain control of the steering wheel?

  • 9. Does the employee avoid distractions? No phone usage, eating, or drinking while driving?

  • 10. Does the employee drive at or below the posted speed limit?

  • 11. Does the employee maintain a gap of at least four seconds when following another vechicle?

  • 12. Does the employee tap breaks, slow down and move over, if possible, when being followed to closely or tailgated?

  • 13. Does the employee decrease speed well in advance of intersection?

  • 14. Does the employee reduce speed, increase following distance, and use wipers and headlights during inclement weather?

  • 15. Does the employee frequently check mirrors and frequently observe vehicles in adjacent lanes? (Every 5-8 seconds)

  • 16. Does the employee look 1/2 mile or 1.5 city blocks ahead?

  • 17. When passing does the employee signal when pulling out and back in and do they allow sufficient distance to clear the passed vechicle? (2 second gap)

  • 18. Does the employee check adjacent lanes for traffic before changing lanes?

  • 19. Does the employee stop at crosswalk lines and intersection stop lines?

  • 20. Does the employee reduce speed when pedestrians approach the roadway and yield right-of-way to pedestrians?

  • 21. Does the employee travel below posted speed limit and keep eyes moving when in residential areas or near parks or schools?

  • 22. Does the employee check the mirrors before applying the breaks?

  • 23. Does the employee reduce speed when approaching vision-obstructed intersections?

  • 24. Does the employee look left, right, left, and yield to cross traffic at intersections?

  • 25. Does the employee observe all traffic signals and signs? ( Comes to a complete stop at stop signs and red lights before turning right.)

  • 26. Does the employee slow down gradually when stopping?

  • 27. When stopped at stop sign or red light, does the employee leave at least one vehicle length between the vehicles?

  • 28. Does the employee turn from and maintain the proper lane while turning?

  • 29. When turning does the employee signal well in advance (100 feet)?

  • 30. When parking, does the employee avoid backing when possible?

  • 31. Did the employee turn the front wheels to the curb and set the parking brake ?

  • 32. Did the employee back slowly and use a spotter or single point backing when a spotter is not available?

  • Add signature

  • Comments:

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.