Title Page
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Serial Number
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Site conducted
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Conducted on
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Prepared by
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Location
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Document Number
Repeat Section
- Sample Section
Section 1
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Question for Section 1
Section 2
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Question for Section 2
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Checkbox
Notification Test
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Test
Instructions Sample
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Did you do it correctly?
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Do it correctly
Testing for Report Preview
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Initial Question
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Secondary Question
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Is this suppose to show up in the report preview?
Custom Response Set
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Did the driver enter the location in a uniform and park safely?
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Did the driver turn on hazard lights, lock door, and exit the unit with delivery ticket and BOL?
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Did the driver verify the address and double check compartment markers vs delivery ticket?
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Did the driver set out 4 safety cones to create a safe work area and place yellow cone on DC tank? (Minimum is 2 cones if work area is physically blocked off.)
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Did the driver hook up the vapor recovery hose first?
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Did the driver stick the tank with water indicating paste and record 90% safe fill readings on the delivery ticket?
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Did the driver drop DC first and was the DC compartment labeled with "Diesel" tags?
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Did the driver work from the ground up? (1) Drop gun, (2) Hose connected to drop gun, (3) Hose to compartment)
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Did the driver double check the hose connection from the tank to the compartment before pulling the lever?
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Did the driver stay within 5' of the calve manifold while dropping?
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Did the driver empty the hoses, places caps on tanks, move markers to red/empty, close valves and secures hoses in the tray?
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Did the driver use a phone while dropping fuel?
Text Answer
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Type Text below - Short
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Type Text below - Paragraph
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Add drawing
Number Response
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Type Numbers
Checkbox Response
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Check this box
Date & Time
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Insert a date and time
Media Response
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Add a media
Slider Response
Instruction
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What are your top three forms of violence
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Rank 1
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Rank 2
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Rank 3
Signature
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Add signature
