Title Page

  • Inspection Type

  • Division

  • Conducted on

  • Prepared by

  • Location
  • Employee Name/Division/Crew/Truck Number

PPE

  • Hat for sun protection

  • Boots in good condition

  • New way long sleeve shirts & pants worn

  • Hardhat

  • Hearing Protection/ Tapones Oreja

  • Extra PPE

  • Gloves/ Guantes

  • Safety Glasses or goggles/ Lentes

Pesticides

  • 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

Vehicle

  • 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

Trailer

  • Hub seals in place

  • Tires/ Leaf Springs in good condition

  • Fuel/ Fertilizer stored properly

  • Fuel properly mixed (1.3oz/gal)

Final

  • Additional Findings/Comments

  • Employee Signature

  • Inspector Signature

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.