Lookout/Site Warden Kit Checklist

• Site conducted

  Select

• Full Name/Team/Contractor:

• Date:

  Date

• Prepared by:

• Project Title:

• ELR & Mileage:
  Address

• Weather & temp:

• ALL LOOKOUT KITS SHOULD CONTAIN THE FOLLOWING ITEMS:

• Flag blue and white checks (915mm x 915mm)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Flag red (915mm x 915mm)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Moulded whistle

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Plastic horn

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Hand torch (with capability of showing red aspect)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Lookout armlet

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Site Warden armlet

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Track circuit clip (in bag unopened)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Sufficient fog signals (stored in red plastic container - minimum within 5 years of date, and straps must be attached)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Lookout bag

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• First aid kit (optional)

  Yes

  No

  N/A

• Condition?

  Good

  Average

  Worn

• Comments:

Actions to be entered into CMO:

• Enter an Action, an Action Owner, and an Action Date.
  If N/A, enter “No actions”.

• 1.

• 2.

• 3.

• 4.

• 5.

• 6.

• 7.

• 8.

• All actions have been assigned correctly, and Close Calls recorded where required.

  Sign