Wears eye protection? (goggles, safety glasses)
Wears face protection? (face shield over goggles and glasses)
Wears cut and moisture-resistant gloves?
Wears hearing protection when required?
Does not wear loose clothing or jewelry?
Wears class 2 high visibility clothing when on road calls or working outside of shop?
Wears hard hat when required?
6" high work boots are being worn?
Keeps fire exits and paths clear?
Completes and follows hot work permits?
Combustibles removed ,or protects it with fire resistant barriers?
Cordons off area before wielding or cutting?
Uses stairway handrails?
Keeps walk area clear?
Reports any spills immediately?
Walks does not run?
Watches where stepping?
Gets close to equipment to minimize reaching?
Avoids twisting back motions or excessive back bending?
Lifting technique? ( bends at the knees and lifts)
Unsafe acts not covered above? ( please write in notes column)
Unloads vehicle safely?
Follows rule prohibiting scavenging?
Turns off truck to avoid leaving it idle?
Only operates if trained by a SWACO trainer?
Wears seatbelt as required by SWACO policy?
Checks both ways and to rear before operating any motorized equipment?
Sounds horn when backing and at all blind spots?
Does not lift more than truck can safely carry?
Follows equipment specific lockout procedures?
Applies locks and or tags as required? (SWACO SOP)
Mechanics/Employee comments and signatures.
Corrective action required? ( Explain any action and date when to be completed by)