Information

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Personnel And Equiptment

  • Select date

Description of job

  • Job being performed

  • Secondary or Distribution

  • Energized or de-energized work

  • Overhead, underground, or right-of-way

Job Preparation

  • Job briefing was conducted and documented

  • Radio operation check was performed

  • Pre-trip inspection was performed on CMV

  • Pre-flight of aerial unit was performed

  • Energy source controls (LOTO) have been identified

  • Hazards discussed

  • Breaker on one-shot

  • Line Tagged

Personal Protective Equipment

  • Hard hat worn properly and in good condition

  • Eye protection worn

  • Proper hand protection

  • Safety toed boots

  • Hearing protection available

  • FR clothing in good condition

  • Rubber gloves worn and inspected prior to use

  • Rubber sleeves worn and inspected prior to use

  • Fall protection (buck squeeze - bucket truck harness)

  • Additional cover-up

  • Chainsaw Chaps

Grounding

  • Truck grounds are being used and in good condition

  • Personal grounds are being used and in good condition

  • Crew members can explain proper grounding techniques

  • Grounds are properly stored

  • Conductor was tested prior to grounds being installed

Vehicles

  • Diggers/Buckets are properly set up

  • Wheel chocks are being used

  • All material on the vehicle is properly stowed

  • Outrigger pads are being used

  • Reverse alarm is in working order

  • Fire extinguishers are properly charged and stored

  • First aid kit is stocked and location is properly marked

  • AED is available and location is properly marked

Traffic control

  • Beacon/strobe lights are working and being used

  • Traffic cones are used and properly placed

  • Road signs are adequate for the job being performed

  • Reflective vests are worn

  • A flagger is being used to control traffic

General work practices

  • Proper tools are being used to complete the task

  • Tools have been inspected and are in good condition

  • Live line tools have been inspected prior to use and tested within 2 years

  • Hand lines are available and in good condition

  • Ladders have been inspected and are in good condition

  • Excavations are safe and properly shored

  • Poles are tested prior to climbing

  • Adequate cover-up material is being used

  • Employees performing hot work are being observed by a safety watcher

  • Guards are in place on tools and equipment that need them

  • Clear communication is exchanged among crew members

  • Employees can explain direction of feed and closest protection device

Comments

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.