• Employee Name/Division/Crew/Truck Number


  • 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


  • 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

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