Monthly Site Inspection & Equipment Checklist

• Truck #

• Location
  Address

• Date

  Date

• Inspected by:

• Nearest First Aid Attendant:

• ETV Location
  Address

• Number of Fire Tools, Extinguishers:

• Number of Spill Kits:

• First Aid Kit Level:

  Level 1

  Level 2

  Level 3

  N/A

PPE / Tools / Machine

• Hi-Vis / Hard Hat / Gloves / Footwear

  Good

  Repair

  Replace

• Hearing / Eye Protection / Soft Hammer

  Good

  Repair

  Replace

• Water tank / Exhaust system

  Good

  Repair

  Replace

• Stamp Hammer Correct

  Good

  Repair

  Replace

• No loose objects in cab / Safe work procedures followed

  Good

  Repair

  Replace

• Seatbelts in place & used

  Good

  Repair

  Replace

• Horn / Signalling backing in/out

  Good

  Repair

  Replace

• Stairs / Ladder / Railings / 3 point contact

  Good

  Repair

  Replace

• Windows / Wipers / Radio works

  Good

  Repair

  Replace

• Pre-Trip / Call out km's / Tug test

  Good

  Repair

  Replace

• Steep grade discussed / Signage

  Good

  Repair

  Replace

• Snubbing / Towing / Pushing when needed

  Good

  Repair

  Replace

• Uses binders / Load secure for travel

  Good

  Repair

  Replace

• Stake strap / Lifting strap condition

  Good

  Repair

  Replace

• Turn outs adequate size / Number

  Good

  Repair

  Replace

• Stake at 90% / Compensator pin condition

  Good

  Repair

  Replace

• Maxis applied where required

  Good

  Repair

  Replace

• Site congestion 2' clearance

  Good

  Repair

  Replace

• Overhead hazards

  Good

  Repair

  Replace

• Drips / Leaks managed / Litter removed

  Good

  Repair

  Replace

• In Case of Accident Sheet information in truck

  Good

  Repair

  Replace

• Add signature

  Sign