Information

  • Audit Title

  • Auditor Employee Number

  • Station

  • Flight Audit

  • Audit
  • Time

  • Gate Number

  • Aircraft number

  • Aircraft Type

  • 1. WEAR PPE - ( Ear Protection/Safety Vest) ?

  • Error Codes

  • Other

  • Notes:

  • 2. Safety zone clear ?

  • Error Codes

  • Other

  • Notes

  • 3. Proper arrival procedures followed ?

  • Error Codes

  • Other

  • Notes

  • 4. Aircraft chocked properly ?

  • Error Codes

  • Other

  • Notes

  • 5. Proper hand signals used ?

  • Error Codes

  • Other

  • Notes

  • 6. Gate services procedure followed ?

  • Error Codes

  • Other

  • Notes

  • 7. Towbar connected according to procedures?

  • Error Codes

  • Other

  • Notes

  • 8. Proper cone placement ?

  • Error Codes

  • Other

  • Notes

  • 9. Safety stops performed ?

  • Error Codes

  • Other

  • Notes

  • 10. Fwd/Aft Beltloaders positioned correctly ?

  • Error Codes

  • Other

  • Notes

  • 11. Fwd/Aft Beltloaders chocked properly?

  • Error Codes

  • Other

  • Notes

  • 12. Gate services disconnected according to procedures ?

  • Error Codes

  • Other

  • Notes

  • 13. Fwd/Aft Lavs completed according to procedures?

  • Error Codes

  • Other

  • Notes

  • 14. Walkaround complete prior to push ?

  • Error Codes

  • Other

  • Notes

  • 15 Guide agent following procedures ?

  • Error Codes

  • Other

  • Notes

  • 16. Aircraft pushed according to procedures ?

  • Error Codes

  • Other

  • Notes

  • 17. Proper pushback disconnect procedures followed ?

  • Error Codes

  • Other

  • Notes

  • 18 Proper driving procedures followed?

  • Error Codes

  • Other

  • Notes

  • 19. MP3/cell phone policy followed ?

  • Error codes

  • Other

  • Notes

  • 20. FOD walk completed prior to A/C arrival and push ?

  • Error codes

  • Notes

  • 21. Did agent verify battery type ?

  • Error Codes

  • Other

  • Notes

  • 22. Was power source disabled ?

  • Error codes

  • Other

  • Notes

  • 23. Was inspection tag filled out ?

  • Error Codes

  • Other

  • Notes

  • 24. Was the captain notified ?

  • Error codes

  • Other

  • Notes

  • 25. Is Agent Brake Ride Qualified ?

  • Error Codes

  • Other

  • Notes

  • 26. Towing procedures followed?

  • Error Codes

  • Notes

  • no label

Misc :

  • M1: FOD present in general ramp area

  • M2 : MP3/cell phone used while driving on service road

  • M3: Agent riding belt in/out of bin

  • M4 : Night wands used according to procedure

  • M5 : Pre-push briefing completed according to procedure

Environmental

  • Spill kits complete ?

  • Waste stored properly ?

  • Potable water/filler cabinets properly maintained

  • Potable water trucks/carts properly maintained

  • Powercord heads in good condition ?

  • WN - 1035A filled out and retained for 12 months ?

  • WN - 1035B filled out and retained for 5 months ?

  • WN - 1055 filled out and retained for 12 months ?

  • WN - 1102 filled out and retained for 12 months ?

  • Damage investigation Kit readily Available ?

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.