Title Page

  • Inspection Type

  • Division

  • Conducted on

  • Prepared by

  • Location
  • Work area


  • Safety Glasses in use

  • Safety Boots in good condition

  • Long pants worn while trimming

  • High Viz shirt or vest worn

  • Hearing Protection while using equipment

  • Sun shade or hat used

  • Additional PPE used when necessary

Pesticide and Fertilizer Application

  • Are you applying pesticides? or Fertilizer

  • SDS's available

  • Pesticide Safety Products (Soap, paper towels, tyvek)

  • Chemicals Labeled

  • Pesticide PPE


  • Is a vehicle or trailer on jobsite

  • Weekly Inspection completed accurately

  • F/A kit onboard and stocked

  • Cones around truck

  • Wheel chocks used

  • Employees using 3 points of contact to enter/exit

  • Not overfilled?

  • Heat Illness Prevention Program

  • Tires, Lights, License Plate, Mirrors in serviceable condition

  • Tools in serviceable condition/ Secured

  • Fuel/ Fertilizer stored properly

  • Trailer lights working

  • Equipment secure on trailer?


  • 3 Points of contact while ascending/descending ladders or stairs?

  • Using proper Lifting / Twisting technique?

  • Protected from Line of fire? Caught-in, Struck by, Energy Release

  • Workers keeping hands out of danger zone?

  • Workers staying focused...Eyes on path?


  • Additional Findings/Comments

  • Inspector Signature

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