Title Page
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VPL AURORA FIELD OBSERVATION AND COMPETENCY CHECK FORM Rev: 20170419.1
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NAME
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Check No.
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Conducted on
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Prepared by
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Location
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SITE SET UP SAFELY
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CORRECT PPE USED
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CAN CARRY OUT A POLE INSPECTION
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CAN CARRY A LADDER SAFELY
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CAN SET UP A LADDER CORRECTLY
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BOTTOM ROPE USED
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CAN SAFELY CLIMB LADDER
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TOP HEAD ROPE USED
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UNDERSTANDS HOW TO USE POLE STRAP ON HARNESS
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KNOWS MAXIMUM APPROACH DISTANCES. (MAD)
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CAN SAFELY WORK ON TOP OF THE LADDER
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KNOWS WHAT THE TOP MOST STEP THAT CAN BE STOOD ON IS
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UNDERSTANDS AND CAN IDENTIFY THE DIFFERENCE BETWEEN A POWER POLE AND A CHORUS POLE
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CAN FILL OUT THE DELTA 'WORK AUTHORITY' FORM CORRECTLY
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Notes:
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Photograph of site
