Employee Name/Division/Crew/Truck Number


Hat for sun protection

Boots in good condition

New way long sleeve shirts & pants worn


Hearing Protection/ Tapones Oreja

Extra PPE

Gloves/ Guantes

Safety Glasses or goggles/ Lentes


Pesticide Binder (N8/ Poison Control & Clinic info, SDS')

Pesticide Safety Products (Soap, paper towels, tyvek)

Locked Pesticide Box & Sprayer

Chemicals Labeled

Pesticide PPE

Chemicals stored and labeled properly

SDS for chemicals onboard/sprayed


Daily use reports completed accurately

F/A kit onboard and stocked

Cones around truck

Water Filled and Cups

Fire Extinguisher/ Serviced within the past year

Truck medical clinic posting

Heat Illness Prevention Program

Tires, Lights, License Plate, Mirrors in serviceable condition

Tools in serviceable condition/ Secured


Hub seals in place

Tires/ Leaf Springs in good condition

Fuel/ Fertilizer stored properly

Fuel properly mixed (1.3oz/gal)


Additional Findings/Comments

Employee Signature
Inspector Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.