Information

  • Document No.

  • Conducted on

  • Prepared by

  • Location

Driver Information

  • Driver Name

  • Route Number

DOT Inspection Book/Log Book

  • Driver logged into Samsara ?

  • Properly Logged into DSDI to invoice customers?

  • Logged into GreenMile

  • EDVIR pre trip completed?

Driver Appearance/PPE

  • Driver in proper uniform?

  • Uniform (no rips/not able to snag).

  • Wearing slip resistant shoes with a safety toe?

  • Wearing safety gloves?

Driving Habits

  • Driver refrains from using a hands free electron device while operating a company vehicle?

  • Driver refrains from using personal electronic devices?

  • Follows driving a laws and regulations?

  • Driver refrains from using phone/texting while driving?

  • Maintains appropriate speed?

  • Maintains proper lane discipline?

  • Maintains appropriate following distance?

  • Driver refrains from eating, drinking, smoking. Not distracted

  • Courteous to other drivers?

Backing

  • Safe backing performed?

  • G.O.A.L- Get Out And Look used if necessary?

  • Drive announced intentions before backing? Honked Horn?

Product Delivery

  • Delivery made within customers delivery window?

  • Driver bends at the knees not the waist to open the trailer door

  • Driver uses door control and shuts the trailer door after taking each pallet off

  • Operates pallet jack safely ( horn, walks to the side)?

  • Pallys placed neatly in the cooler?

  • Milk pallets placed neatly in the cooler?

  • All empty pally and trays picked up?

  • Invoice Signed?

Trailer Appearance

  • Product and empties properly loaded in trailer for even weight distribution?

  • Load properly secured?

  • Pallets stacked safely?

  • Empty Pally and trays stacked neatly and secured?

  • Pallet jack safely stowed?

  • Dock plate picked up and safely stowed

Tractor Appearance

  • Tractor cab clean?

  • Safety binder in tractor?

  • Spill Kit in tractor?

  • Fire Extinguisher present and secured?

  • Tractor doors are locked while delivery is being made?

Supervisor Signature

  • Add signature

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.