Information
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Customer
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Conducted on
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Prepared by
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Location
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TSU One Supervisor
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Foreman
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Personnel
1.Audit
2. Job safety hazard analysis (JHA) completed
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JHA complete as required
3. Bucket Truck
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Truck number401
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Registration current
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Has the DVIR been completed
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Has both license plates
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CURRENT DOT inspection
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Wheel chocks and outrigger pads on all equipment where required
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Is dielectric testing current
- Yes
- No
- N/A
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Dielectric test date
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Truck cab are clean and free of debris
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Belly of truck clean and clear for egress
4.Traffic Control
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Are cones placed in roadway
5. PPE
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Rubber gloves have been dielectrically tested within range (6 months stamp/sharpie)
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Rubber sleeves have been dielectrically tested within range (12 months stamp/sharpie)
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Rubber blankets have been dielectrically tested within range (12 months stamp/sharpie)
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Rubber gloves are being worn when required
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Sleeves are being worn when required
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Blankets being used when required
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Employees working aloft are wearing non-conductive body harness
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And lanyard attached to the proper anchor point
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Hard hats, road vest, safety glasses, and leather gloves worn as required
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Proper FR clothing worn as required
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Is there a qualified ground and bucket rescue person
6. Safety Protective Grounds(SPG's)
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All equipment requiring grounds are grounded, bonded or barricaded
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Rubber goods stored to prevent damage
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Energized conductors and equipment properly covered
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Neutral and all secondary points of contact properly covered
7. Crane Trucks
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Daily inspection complete
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Outriggers and pads properly applied
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Man basket free of debris and in good working order
8. Rigging Inspection
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Rating Tag, Checked for damage etc.
Comments
9. TRAILER
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Is there a trailer on site?
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a. TRAILER NUMBER?
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b. IS REGISTRATION CURRENT ON TRAILER?
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c. DOES THE TRAILER HAVE A LICENSE PLATE?
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d. DOES THE TRAILER FLOOR HAVE HOLES?
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e. TIRES-GOOD TREAD DEPTH/EVEN WEAR/LUG NUTS?
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f. TRAILER LIGHTS GOOD CONDITION?
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g. TRAILER BREAK AWAY CABLE ATTACHED AND IN GOOD CONDITION?
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h. IS BREAKAWAY BATTERY CHARGED/GOOD CONDITION?
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I. TRAILER CHAINS ATTACHED PROPERLY?
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j. TRAILER RAMPS IN GOOD CONDITION?
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k. TRAILER HITCH RECIEVER IN GOOD CONDITION?
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l. DOES TRAILER HAVE AN ADEQUATE SPARE TIRE?
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m. OVERALL CLEANLINESS?
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ADDITIONAL COMMENTS
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Comments
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