Key Energy Services, CSA System Check

• Document No.

• Conducted on

  Date

• Client / Site

• LOB & District Numbers, City & State Names

• Marketplace

  Select WCMP PBMP GCMP CMP NEMP RMMP International

  • WCMP
  • PBMP
  • GCMP
  • CMP
  • NEMP
  • RMMP
  • International
• Location of system check - select from locator icon
  Address

Driver License Check:

• Does the driver have a license available to review?

  Yes

  No

  N/A

• Is the license valide?

  Yes

  No

  N/A

• Is it the proper class for the vehicle driven?

  Yes

  No

  N/A

• Does the driver have a medical card available to review?

  Yes

  No

  N/A

• Is the medical card legible and valide?

  Yes

  No

  N/A

Federal Hour of Service (HOS) (Use appropriate state HOS where applicable)

• Driver has a minimum of 7 logs plus current day for review?

  Yes

  No

  N/A

• Driver has not driven more than 11 hours following 10 consecutive hours off duty?

  Yes

  No

  N/A

• Driver has not driven beyond the 14th hour after coming on duty following 10 hours off duty?

  Yes

  No

  N/A

• Driver has not driven after 70 hours on duty in 8 consecutive days?

  Yes

  No

  N/A

• Driver has available hours to complete the scheduled work for this day?

  Yes

  No

  N/A

• Driver has documented a period of at least 30 minutes off duty in the previous 8 hours before showing driving time?

  Yes

  No

  N/A

• Driver daily logs are legible and up to date?

  Yes

  No

  N/A

Driver Vehicle Inspection Report (DVIR)

• Previous shift DVIR is available for review?

  Yes

  No

  N/A

• Any deficiencies documented have been addressed and validated on the original form by reflecting 3 signatures?<br>

  Yes

  No

  N/A

• Driver has completed a pre-trip inspection?

  Yes

  No

  N/A

• All marker, running, brake & head lights are functioning correctly?

  Yes

  No

  N/A

• All loose items on the vehicle have been secured?

  Yes

  No

  N/A

• Brake hoses between the tractor and trailer are not rubbing and do not show signs of wear?

  Yes

  No

  N/A

• Brakes are in good adjustment? (Steering within 1-3/4", Drive & Trailer within 2")

  Yes

  No

  N/A

Best practice identified during process check

• Pictures of best pracitice

  Media

• Comments supporting best practice pictures

• Drivers Signature:

  Sign

• Auditors Signature

  Sign