Three Rivers Job Site Audit - Updated 2-23-2018

• Three Rivers Electric Cooperative Job Site Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

• Select date

  Date

Job Site Information

• Describe Work Being Performed

• Type of work being performed

  Select Overhead Primary Underground Primary Overhead Secondary Underground Secondary Electrical Equipment / Metering Special Equipment Other

  • Overhead Primary
  • Underground Primary
  • Overhead Secondary
  • Underground Secondary
  • Electrical Equipment / Metering
  • Special Equipment
  • Other

• Work is being performed

• Grounded Work

• Grounds and LO/TO In Place

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Isolated Work

• Energized Work

Crew Information

• Crew Leader

  Select Mike Buscher Matt Holzer Matt Corum Mike Heckman Tim Heckman Roger Berhorst Blake Bopp Andy Buschjost Shannon Curran Logan Gentges Ryan Hackann Matt Jarrett Cory Kleffner Jim Klouzek Anthony Luebbering Brad Libbert Travis Lumpkin Travis Miles Clint Pickett Mike Schwaller Casey Schwartz Matt Siefert Justin Wegman Brad Wolfe Brian Backes Casey Baumhoer Tyler Wieberg

  • Mike Buscher
  • Matt Holzer
  • Matt Corum
  • Mike Heckman
  • Tim Heckman
  • Roger Berhorst
  • Blake Bopp
  • Andy Buschjost
  • Shannon Curran
  • Logan Gentges
  • Ryan Hackann
  • Matt Jarrett
  • Cory Kleffner
  • Jim Klouzek
  • Anthony Luebbering
  • Brad Libbert
  • Travis Lumpkin
  • Travis Miles
  • Clint Pickett
  • Mike Schwaller
  • Casey Schwartz
  • Matt Siefert
  • Justin Wegman
  • Brad Wolfe
  • Brian Backes
  • Casey Baumhoer
  • Tyler Wieberg

• Crew

  Select Mike Buscher Matt Holzer Matt Corum Mike Heckman Tim Heckman Roger Berhorst Blake Bopp Andy Buschjost Shannon Curran Logan Gentges Ryan Hackann Matt Jarrett Cory Kleffner Jim Klouzek Anthony Luebbering Brad Libbert Travis Lumpkin Travis Miles Clint Pickett Mike Schwaller Casey Schwartz Matt Siefert Justin Wegman Brad Wolfe Brian Backes Casey Baumhoer Tyler Wieberg

  • Mike Buscher
  • Matt Holzer
  • Matt Corum
  • Mike Heckman
  • Tim Heckman
  • Roger Berhorst
  • Blake Bopp
  • Andy Buschjost
  • Shannon Curran
  • Logan Gentges
  • Ryan Hackann
  • Matt Jarrett
  • Cory Kleffner
  • Jim Klouzek
  • Anthony Luebbering
  • Brad Libbert
  • Travis Lumpkin
  • Travis Miles
  • Clint Pickett
  • Mike Schwaller
  • Casey Schwartz
  • Matt Siefert
  • Justin Wegman
  • Brad Wolfe
  • Brian Backes
  • Casey Baumhoer
  • Tyler Wieberg

• Trucks and Equipment

  Select Bucket 30 Bucket 32 Bucket 28 Bucket 31 Bucket 33 Bucket 36 Crane 38 Flatbed 35 Dump 27 Digger 21 Digger 23 Digger 26 Truck 3 Truck 4 Truck 5 Truck 8 Truck 9 Truck 10 Truck 11 Truck 13 Truck 14 Truck 6 Truck 7 Truck 12 Truck 15 Truck 17 Truck 18 Digger 20 Digger 25 Bucket 22 Bucket 24 Dump 29 Bucket 37 Bucket 39 Bucket 34 Bucket 37 Chipper Backhoe Bobcat Mini Excavator Stringing Tensioner

  • Bucket 30
  • Bucket 32
  • Bucket 28
  • Bucket 31
  • Bucket 33
  • Bucket 36
  • Crane 38
  • Flatbed 35
  • Dump 27
  • Digger 21
  • Digger 23
  • Digger 26
  • Truck 3
  • Truck 4
  • Truck 5
  • Truck 8
  • Truck 9
  • Truck 10
  • Truck 11
  • Truck 13
  • Truck 14
  • Truck 6
  • Truck 7
  • Truck 12
  • Truck 15
  • Truck 17
  • Truck 18
  • Digger 20
  • Digger 25
  • Bucket 22
  • Bucket 24
  • Dump 29
  • Bucket 37
  • Bucket 39
  • Bucket 34
  • Bucket 37
  • Chipper
  • Backhoe
  • Bobcat
  • Mini Excavator
  • Stringing Tensioner

PPE and Safety Precautions

• Job Briefing - Take Photo(s) Please

  Media

• Hard Hat

• Safety Glasses

• FR Clothing

• Hearing Protection

• Rubber Gloves

• Rubber Sleeves

• Fall Protection

• Traffic Vest / Hi-Viz Garment

• Traffic Control - Take Photo(s) Please

  Media

• Personal Protective Ground - Visible From Worksite

• Cover Up - Take Photo(s) Please

  Media

Equipment and Vehicle Safety

• Wheel Chocks

  Yes

  No

  N/A

• Outrigger Pads

  Yes

  No

  N/A

• Daily Inspection

  Yes

  No

  N/A

• Equipment Grounds

  Yes

  No

  N/A

• Hand-line in Bucket

  Yes

  No

  N/A

Overview of Observed Work Practices

• What went well:

• What went well:

  Media

• What needs attention:

• What needs attention:

  Media

• Violation(s) of known safety rules:

• Violation(s) of known safety rules:

  Media