LAVATORY/POTABLE WATER SERVICE

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Report no:

• Lavatory vehicle operating procedures followed<br>

  Safe

  At Risk

  N/A

• Lavatory servicing procedures followed

  Safe

  At Risk

  N/A

• PPE worn

  Safe

  At Risk

  N/A

• Personnel exhibit appropriate work behavior (e.g., no “horseplay”)

  Safe

  At Risk

  N/A

• Personnel use correct manual handling, ergonomics (e.g., proper lifting techniques)

  Safe

  At Risk

  N/A

• Personnel avoid walking where not authorized (e.g., under the fuselage, stepping over towbar, or between carts)

  Safe

  At Risk

  N/A

• All traffic regulation procedures followed

  Safe

  At Risk

  N/A

• Fire extinguisher(s) available/serviceable

  Safe

  At Risk

  N/A

Potable Water Service

• Water vehicle operating procedures followed

  Safe

  At Risk

  N/A

• Water servicing procedures followed

  Safe

  At Risk

  N/A

• Potable water units kept away from lavatory units or other sources of contamination

  Safe

  At Risk

  N/A

• PPE worn

  Safe

  At Risk

  N/A

• Personnel exhibit appropriate work behavior (e.g., no “horseplay”)

  Safe

  At Risk

  N/A

• Personnel use correct manual handling, ergonomics (e.g., proper lifting techniques)

  Safe

  At Risk

  N/A

• Personnel avoid walking where not authorized (e.g., under the fuselage, stepping over towbar, or between carts)

  Safe

  At Risk

  N/A

• All traffic regulation procedures followed

  Safe

  At Risk

  N/A

• Fire extinguisher(s) available/serviceable

  Safe

  At Risk

  N/A

• Signed:

  Sign

AIRCRAFT ARRIVAL/OFFLOAD

• Proper hearing protection is used by all employees.

  Safe

  At Risk

  N/A

• Proper safety footwear is worn by all employees.

  Safe

  At Risk

  N/A

• High visibility /reflective clothing is worn

  Safe

  At Risk

  N/A

• All equipment is positioned outside aircraft clearance lines.

  Safe

  At Risk

  N/A

• The proper hand signals are used by marshaller, if marshaller is used

  Safe

  At Risk

  N/A

• Wands are used for marshalling and all signalling (illuminated in low visibility)

  Safe

  At Risk

  N/A

• Aircraft chocks are properly installed according to airline procedures

  Safe

  At Risk

  N/A

• Personnel wait until the aircraft has stopped, is chocked, anti-collision light off, engines shut down and “all clear” given by marshaller before approaching

  Safe

  At Risk

  N/A

Comments, Findings, Observations:

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