LIGHT & POWER ELECTRIC FIELD SERVICE CREW

LIGHT & POWER ELECTRIC FIELD SERVICE CREW

• Location
  Address

• Client / Site

• Document No.

• Conducted on

  Date

• Prepared by

• SIGNITURE OF AUDITOR

  Sign

PPE

• SAFETY GLASSES

  Yes

  No

  N/A

• HARD HAT

  Yes

  No

  N/A

• GLOVES

  Yes

  No

  N/A

• FR CLOTHING

  Yes

  No

  N/A

• TRAFFIC VESTS

  Yes

  No

  N/A

• STEEL TOE BOOTS

  Yes

  No

  N/A

• HARNESS

  Yes

  No

  N/A

• RETRACTABLES

  Yes

  No

  N/A

• COMMENTS

• HEARING PROTECTION

  Yes

  No

  N/A

JOB SITE

• UTILITIES LOCATED/ GROUNDED

  Yes

  No

  N/A

• EXCAVATION/TRENCH GUARDED

  Yes

  No

  N/A

• HOUSEKEEPING/CLEAR PATHWAY

  Yes

  No

  N/A

• OTHER

  Yes

  No

  N/A

CONFINED SPACE

• RETRIEVAL EQUIPMENT

  Yes

  No

  N/A

• ENTRY PERMIT

  Yes

  No

  N/A

• VENTILATION

  Yes

  No

  N/A

• TRI-POD

  Yes

  No

  N/A

• GAS DETECTOR

  Yes

  No

  N/A

• CALIBRATED

• CHECKED OUT

• OTHER

  Yes

  No

  N/A

TOOLS

• SAFE CONDITIONS EXIST

  Yes

  No

  N/A

• USED CORRECTLY

  Yes

  No

  N/A

• CORRECT FOR JOBTASK

  Yes

  No

  N/A

• OTHER

  Yes

  No

  N/A

EQUIPMENT

• LINE TRUCK

  Yes

  No

  N/A

• FIRE EXTINGUISHER

  Yes

  No

  N/A

• EXPIRATION DATE CHECKED

• ON SITE EQUIPMENT CHECK

  Yes

  No

  N/A

• DOT LOG

  Yes

  No

  N/A

• AED LOG

  Yes

  No

  N/A

• FIRST AID KIT

  Yes

  No

  N/A

• BACK UP ALARMS FUNCTIONING

  Yes

  No

  N/A

• SPOTTER USED FOR BACKING

  Yes

  No

  N/A

• STROBES/WARNING LIGHTS

  Yes

  No

  N/A

• SEAT BELT USE

  Yes

  No

  N/A

• PINCH POINTS (MARKED OR GUARDED)

  Yes

  No

  N/A

• WAS THERE AN OIL SPILL

  Yes

  No

  N/A

• WAS THE SPILL PROPERLY ATTENDED TO?

  Yes

  No

  N/A

OTHER

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