Jacobson & Company PTP - Loading Conditions

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Unloading Area

Is the unloading area clear of:

• Debris

  Yes

  No

  N/A

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• Tripping Hazards

  Yes

  No

  N/A

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• Overhead Hazards

  Yes

  No

  N/A

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• Is there a clear path to the material destination?

  Yes

  No

  N/A

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• Is there a gap between the truck and loading dock?

  No

  Yes

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• Are there pedestrians and/or cars to be mindful of?

  No

  Yes

• Does the area have to be coned off?

  No

  Yes

• Is a flag person required?

  No

  Yes

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• Is there floor and/or wall protection required?

  No

  Yes

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• Will weather conditions be a factor in the task process (ex. rain, snow, slippery surfaces)?

  No

  Yes

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Additional Notes

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