Title Page

  • Site conducted

  • Conducted on

  • Prepared by

Untitled Page

  • DATE & TIME

  • LOCATION
  • TRUCK #

  • DRIVER

  • HOPPER

  • HOPPER

GENERAL

  • Vehicle Cleanliness, Maintenance, Issues Etc

SAFETY

  • Safety Devices, PPE, Uniform, Vest, Seatbelt use Etc

COLLECTION & DISPOSAL

  • Keeps a safe distance, loose waste cleanup, mount & dismount techniques, lifting, can placement, customer interaction, helpers assist w/ backing & driving, handling passing cars Etc

DRIVING

  • Use correct speeds, situational awareness, use of mirrors, maintains spacing around vehicle, stops at signs, use 4-sec following rule, use of turn signals, lights, horns, flashers to communicate

RESULTS

  • ALL NON-COMPLIANT SCORES SHALL RESULT IN EMPLOYEE COACHING FOLLOWING THE OBSERVATION

  • INSPECTOR COMMENTS (INCLUDING NOTES FROM ANY COACHING)

  • INSPECTOR SIGNATURE

  • EMPLOYEE SIGNATURE IF COACHED

  • EMPLOYEE SIGNATURE IF COACHED

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.