Title Page

  • Operations Field Observation

  • Conducted on

  • Prepared by

  • Wolverine Personnel

  • Other Personnel onsite

Job Planning

  • Discussion on site?

  • Job Briefing?

  • Other documentation on site?

  • Proper Job Setup?

  • Does the job plan help reduce the risk of sprains and strains?

Personal Protective Equipment

  • Is eye protection with side shields being worn at all times?

  • Are hard hats worn as required?

  • Is hand protection used?

  • Is footwear appropriate for the job?

  • Is hearing protection used when needed?

  • Is clothing policy being followed?

Vehicles

  • Are wheel chocks used?

  • Was a daily pre-trip inspection performed?

  • Daily preflight inspection on hydraulic equipment performed?

  • Digger/buckets properly setup?

  • Does the operator of the aerial device have a current qualification card?

  • Vehicles grounded, bonded, or barricaded per procedure manual?

  • Are proper backing procedures being followed?

  • Are vehicles parked in a way to avoid backing at a later time?

Overhead Construction

  • Is all equipment inspected prior to use?

  • All equipment used correctly?

  • Is equipotential grounding being used?

  • Working between grounds?

  • Are grounds in good condition?

  • Are hand lines used?

  • Are excavations evaluated and safe?

  • Is the appropriate rescue equipment present?

Energized Work

  • Are gloves and sleeves correct rating and date?

  • Are gloves air tested and visually inspected prior to use?

  • Is adequate cover-up material utilized?

  • Is MAD being maintained?

  • Are hot sticks cleaned before use?

  • Is company policy being followed for proper rubber glove use, hot sticking, and working in energized work areas?

  • Is there an observer being used for hot work activities?

  • Is the proper level of FR clothing being worn?

  • Arc flash glasses being worn?

  • Is the FR clothing tucked in?

  • Proper LO/TO use?

General

  • Are poles tested prior to climbing?

  • Is proper fall protection used?

  • Are slings in good condition?

  • Is climbed equipment checked prior to use?

  • Are gaff guards used?

  • Are ladder requirements and rules being followed?

  • Is work area clean when job is finished?

  • Are substation gates kept closed to keep the public out?

  • Is there an AED on site?

Traffic Control

  • We're beacon/strobe lights used?

  • Were four way flashers used?

  • Were reflective vest used?

  • Were cones adequate for job?

  • Were signs adequate for job?

  • Was law enforcement utilized?

  • Was a flagged used?

  • Other

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.