Poudre Valley Field Inspection

• Audit Title

• Job Description

• Location
  Address

• Conducted on

  Date

• Prepared by

Site Safety

• Are cones out and flashers on if required?

  Yes

  No

  N/A

• Is employee wearing reflective vest if working near traffic?

  Yes

  No

  N/A

• Is vehicle backed in if possible or cone placed behind vehicle if not backed?

  Yes

  No

  N/A

Vehicle

• Is the general housekeeping of the vehicle satisfactory?

  Yes

  No

  N/A

• All material on vehicle is properly stowed?

  Yes

  No

  N/A

• Is first aid kit/BBP kit accessible and within expiration date and properly stocked and location is marked?

  Yes

  No

  N/A

• Has fire extinguisher been inspected and signed off?

  Yes

  No

  N/A

PPE

• Hardhat worn properly and in good condition

  Yes

  No

  N/A

• Approved Eye Protection ANSI Z87 comliant

  Yes

  No

  N/A

• FR Clothing - Tucked in, buttoned up, sleeves rolled down

  Yes

  No

  N/A

• Hearing Protection - if over 85 dbi

  Yes

  No

  N/A

• Hand Protection if needed

  Yes

  No

  N/A

• Notes