HEO - Bulldozer - Field Exam

• Candidate Name - HEO Field Exam - Dozer

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• The performance verification is designed as one method to a evaluate job skills and safe work habits of a participant. The performance of the participant must be evaluated by a designated W.C. Spratt, Inc. evaluator at an authorized location. Candidates must have a minimum passing score of 90% to pass any field exam portion of the heavy equipment operator training program.

Employee Information

• Employee name:

• Employee number:

• Employee photo:

  Media

Bulldozer Equipment Type (Make and Model):

• From the manufacturers plate please obtain this information and enter here;

Operator Details

• If an operator has no proof of training held on record, they must not operate until proof of training competency has been proven. (Classroom CAT Training and Successful Completion).

• Has the operator had a valid certificate of training that has been passed or refreshed within the last three years?

  Yes

  No

  N/A

• Has the operator an up to date authorization to operate, signed and renewable annually?

  Yes

  No

  N/A

• Date of test or refresher course?

  Date

• Photo of that certification:

  Media

Pre-start Inspection:

• Did the operator verify all safety items are identified; such as the fire extinguisher, warning signs guards, etc:

  Yes

  No

  N/A

• Did the operator position barricades and appropriate warning signs?

  Yes

  No

  N/A

• Did the operator properly position the bulldozer for pre-start inspection?

  Yes

  No

  N/A

• Did the operator complete the daily pre-operation check list? (This is done using the appropriate form within the iauditor suite).

  Yes

  No

  N/A

• Did the operator visibly check the tracks, rollers, idler, and sprocket conditions?

  Yes

  No

  N/A

• Did the operator visibly verify the blade condition?

  Yes

  No

  N/A

Job Site Survey:

• Did the operator identify potential site hazards such as but not limited; to high-voltage lines or underground utilities?

  Yes

  No

  N/A

• Did the operator identify and verify grade stakes?

  Yes

  No

  N/A

• Did the operator verify safety of equipment set-up

  Yes

  No

  N/A

Start-up and Warm-up of Dozer:

• Did the operator successfully start the engine?

  Yes

  No

  N/A

• Did the operator check the engine gauges for proper readings?

  Yes

  No

  N/A

• Did the operator check all controls for proper function such as but not limited to; the blade, steering and travel?

  Safe

  At Risk

  N/A

• Did the operator properly document their findings on the required checklist?

  Safe

  At Risk

  N/A

Perform Basic Maneuvering Skills:

• Did the operator position the dozer as instructed for the exercise?

  Yes

  No

  N/A

• Did the operator travel the dozer forward for at least 20 feet?

  Yes

  No

  N/A

• Did the operator travel the dozer in reverse for at least 20 feet?

  Yes

  No

  N/A

• Did the operator accomplish a gradual turn of at least 180° with the blade up?

  Yes

  No

  N/A

• Did the operator accomplish a sharp turn of at least 180° with the blade up?

  Yes

  No

  N/A

Perform Basic Blade Operations:

• Is the operator able to position the dozer as instructed for the exercise?

  Yes

  No

  N/A

• Is the operator able to lift and lower the blade?

  Yes

  No

  N/A

• Is the operator able to angle the blade?

  Yes

  No

  N/A

• Is the operator able to tilt the blade?

  Yes

  No

  N/A

• Is the operator able to pitch the blade?

  Yes

  No

  N/A

Perform Basic Dozing Skills:

• Is the operator able to position the dozer as instructed for the exercise?

  Yes

  No

  N/A

• Is the operator able to perform a straight dozing operation by pushing the designated materials straightforward and ahead of the dozer, pushing the greatest amount of material possible?

  Yes

  No

  N/A

• Is the operator able to perform the cutting of a slope the width of the blade at a 1 to 2% angle?

  Yes

  No

  N/A

• Is the operator able to perform the building of a stockpile while maintaining proper windrows and berms?

  Yes

  No

  N/A

• Is the operator able to complete a finished pad 20' x 20' equal to less than 1/10 of a foot?

  Yes

  No

  N/A

Dozer Shut-Down:

• Is the operator able to move the dozer to the designated shutdown area?

  Safe

  At Risk

  N/A

• Is the operator able to properly shut down and secure the dozer?

  Safe

  At Risk

  N/A

Safety:

• Did the operator use all necessary PPE properly?

  Safe

  At Risk

  N/A

• Did the operator properly place all safety notices for the exercise?

  Safe

  At Risk

  N/A

• Did the operator properly follow all safety checklist and site-specific safety requirements?

  Safe

  At Risk

  N/A

• Did the operator practice overall good safety procedures and use of the tools and assigned equipment?

  Safe

  At Risk

  N/A

Assessment Recommendations & Evaluations

• Has the operator successfully completed with positive results all of the previous criteria?

  Yes

  No

  N/A

• Please select the candidate operator's recommendation for this field exam:

  Pass

  Fail

• Please detail basis for failure:

• Please select future date for retest:

  Date

Signatures

• Candidate operator signature:

  Sign

• Assessor signature:

  Sign