Title Page
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Conducted on
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Prepared by
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Location
Assessment
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Rail operations in progress
Record Keeping
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Job briefing completed
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Training records
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RORW conducted
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Ethics Hotline poster posted in common area
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Posted list of LOTO authorized employees
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Emergency reporting phone numbers posted
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Near misses reported
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Track inspections
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Locomotive inspections
Signage
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Site map at entrance
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Loader has right of way
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Posted speed limit
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Overhead power lines
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Low clearances
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Arc Flash labeling
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Confined spaces
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Overweight sign at scale house
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Hearing protection required where required
Slip, Trip, Fall Hazards
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Walking surfaces clear of debris
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Yard ground conditions smooth
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Ladders in good working condition
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Leading edges have proper protection
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Handrails in good working condition
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Grip tape in good working condition
P.P.E.
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No loose clothing
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Shirts/Tear away Vests are high visibility and have 1/4" sleeves
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No loose jewelry
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Lace up leather safety boots minimum 6" ankle coverage
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Hearing protection where required
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Safety glasses when required
Safe Behaviors
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Red Zone clearance maintained
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Cell phone use in designated area
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Use of designated walking paths
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Use of 3 points of contact
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Observed safe behavior
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Use of seat belt
Mobile Equipment
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Pre-trip inspections completed
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3 point contact stickers in place
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Flex steps in good condition
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House keeping
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Backup alarm functional
Track Safety
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Blue Flag Signal displayed when required
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Use of 3 step protection when required
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Track Clearance Points clearly marked
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3 part communication being performed
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Chocks being used when required
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Derail(er) in place where required
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End of train device (EOT) mounted on last car of a train during shove movements
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Watchman/Lookout in place when roadway workers are present
Best Practices
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Any Best Practices observed
