LNA Fleet Safety Recognition Program Housekeeping Checklist REV2

• Tractor/Trailer Numbers

• Site

• Conducted on

  Date

• Personnel

Truck Cab - General Condition

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• Clean/Free of Waste (Spills, Dust, Accumulation Cleaned Regularly)

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Clear/Free of Obstructions (Loose Items in Cab Secured)

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Hazard Triangles In Good, Working Condition

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• SmartDrive Cameras are Not Obstructed or Adjusted

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Fire Extinguishers are Available and Accessible; Fire Extinguisher Inspection Tags are In Place

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Chemical Bottles are Labeled

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

Truck Exterior - General Condition

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• Steps are Clean/Free of Accumulations, Obstructions; Not Damaged

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• DOT Numbers are Legible from 50 Feet

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• License Plates are Clean/Free of Accumulations

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Adequate Reflectors on the Rear of the Cab

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Headlights, Turn Indicators, and Break Lights are Clean/Free of Debris

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

Trailer - General Condition

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• No Significant Material Build-Up on Top Of or Underneath Trailer

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Steps & Ladders are Clear/Free of Obstructions; Not Damaged

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Adequate Reflectors on the Rear & Sides

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Mud Flaps are Available and In Good Condition

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

• Break & Turn Indicators are Clean/Free of Debris

  Select 5 - No Deficient Items 4 - 1 Deficient Item 3 - 2 Deficient Items 2 - 3 Deficient Items 1 - 4 or More Deficient Items N/A - Not Applicable

  • 5 - No Deficient Items
  • 4 - 1 Deficient Item
  • 3 - 2 Deficient Items
  • 2 - 3 Deficient Items
  • 1 - 4 or More Deficient Items
  • N/A - Not Applicable

Miscellaneous - Non-Housekeeping Related (NOT COUNTED TOWARDS SCORE)

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