WCA Observation - Hauling

• Client / Site

• Conducted on

  Date

• Driver Name

• Driver 2 / Helper Name

• Observation Location
  Address

• Personnel

• Start Time

  Date

• End Time

  Date

• Truck Number

• Truck Type

• Weather / Lighting

• Valid CDL Driver 1?

  Yes

  No

• Valid CDL Driver 2?

  Yes

  No

• Driver 1 Current DOT Medical Card?

  Yes

  No

• Driver 2 Current DOT Medical Card?

  Yes

  No

• VCR filled out properly?

  Yes

  No

  N/A

Prior Inspection

• Has the last inspection been reviewed?

  Yes

  No

  N/A

• Are there any outstanding actions?

  Yes

  No

  N/A

• Safe Operation

Driving

• Drives at appropriate speed for conditions

  Yes

  No

  N/A

• Keeps appropriate distance between vehicles

  Yes

  No

  N/A

• Changes lanes safely

  Yes

  No

  N/A

• Does not “Zig Zag”

  Yes

  No

  N/A

• Passes properly

  Yes

  No

  N/A

• Yields right of way

  Yes

  No

  N/A

• Drops 5 MPH through intersections

  Yes

  No

  N/A

• Stays out of blind spots & leaves an out

  Yes

  No

  N/A

• Turns from correct lane

  Yes

  No

  N/A

• No left turn from right side drive

  Yes

  No

  N/A

• Uses turn signals properly

  Yes

  No

  N/A

• Slows/Stops carefully (NO skidding)

  Yes

  No

  N/A

• Complete stop at signs/signals – waits 3 seconds

  Yes

  No

  N/A

• Obeys traffic laws

  Yes

  No

  N/A

• Uses seatbelt when required

  Yes

  No

  N/A

• Helpers off riding step when proceeding over 10 mph or more than ¼ mile distance

  Yes

  No

  N/A

• Parks properly

  Yes

  No

  N/A

Backing

• Backs only with NO other option

  Yes

  No

  N/A

• Helpers out of cab & off step while backing

  Yes

  No

  N/A

• Helpers directing truck while backing

  Yes

  No

  N/A

• Helpers kept in driver view while backing

  Yes

  No

  N/A

• NO backing from right side drive

  Yes

  No

  N/A

PPE

• Appropriate gloves

  Yes

  No

  N/A

• Required uniform

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• 6” high work boots, laced all the way up

  Yes

  No

  N/A

• Reflective ANSI II vest/shirt outside vehicle

  Yes

  No

  N/A

• Hard hat when required

  Yes

  No

  N/A

Professional Customer Standards

• Leaves area clean

  Yes

  No

  N/A

• Notifies dispatch/super when repair is complete

  Yes

  No

  N/A

• Follows prescribed service procedures

  Yes

  No

  N/A

• Displays professional attitude with customer

  Yes

  No

  N/A

• Maintains professional appearance of equipment

  Yes

  No

  N/A

• Displays professional personal appearance

  Yes

  No

  N/A

• Safe Operation

Collection

• NO evidence of scavenging/salvaging

  Yes

  No

  N/A

• Secures load (r/o chains, tarp)

  Yes

  No

  N/A

• Loads/unloads vehicle safety

  Yes

  No

  N/A

• Clear of hopper while operating/compacting

  Yes

  No

  N/A

• Mount/dismount (3pt contact)

  Yes

  No

  N/A

• Lifting technique (bends at knees)

  Yes

  No

  N/A

• Proper container handling

  Yes

  No

  N/A

• Lock out/tag out (when cleaning/clearing)

  Yes

  No

  N/A

Vehicle Systems

• Lighting (head, turn, brake, 4ways, tail, etc.)

  Yes

  No

  N/A

• Back up warning alarm & horn

  Yes

  No

  N/A

• Hopper/loading cycle/speed-up OK

  Yes

  No

  N/A

• Registration/insurance information current

  Yes

  No

  N/A

• Warning triangles & fire extinguishers

  Yes

  No

  N/A

• Condition of seatbelts

  Yes

  No

  N/A

• Clean mirrors & windows

  Yes

  No

  N/A

• Wipers & heater

  Yes

  No

  N/A

• Hand holds / steps on body safe / clean

  Yes

  No

  N/A

• Camera monitor / lens clean & functional

  Yes

  No

  N/A

• Clean in cab / front of body / front of blade

  Yes

  No

  N/A

• Cable / hook / safety / latch tie downs

  Yes

  No

  N/A

• Body / cab damage

  Yes

  No

  N/A

• Fluid leaks – where?

  Yes

  No

  N/A

• Tire condition (F-R/L, M-R/L, T-R/L)

  Yes

  No

  N/A

• Clutch/brake pedal pads

  Yes

  No

  N/A

• Door handles inside & out

  Yes

  No

  N/A

• Reflective body tape

  Yes

  No

  N/A

Near Miss Identified

• If yes for “Near Miss Identified”, complete a Near Miss Incident Reporting form

  Yes

  No

  N/A

• Observer comments, positive and corrective

• Driver Signature

  Sign

• Select date

  Date

• Driver / Helper Signature

  Sign

• Select date

  Date

• Safety Director Signature

  Sign

• Select date

  Date

• Site Manager Signature

  Sign

• Select date

  Date