WZTC Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Tailgate Meetings

• Daily Hazards Listed

  Yes

  No

  N/A

• Attendee's signed off

  Yes

  No

  N/A

• Medical Facility listed w/address

  Yes

  No

  N/A

• Weekly Toolbox Talk completed and noted

  Yes

  No

  N/A

Work Zone Traffic Control Set Up

• Signs at proper spacing

  Yes

  No

  N/A

• Signs at proper height

  Yes

  No

  N/A

• Signs and stands in good shape

  Yes

  No

  N/A

• Arrow Board placement OK

  Yes

  No

  N/A

• Arrow board lights working and visable

  Yes

  No

  N/A

• Taper proper length and straight

  Yes

  No

  N/A

• Buffer Zone maintained (no vehicles parked in zone)

  Yes

  No

  N/A

• No vehicles parked behind Attenuator

  Yes

  No

  N/A

Attenuator Truck

• Wheels turned towards shoulder

  Yes

  No

  N/A

• Truck Mounted Arrow Board Working

  Yes

  No

  N/A

• Inspection Current

  Yes

  No

  N/A

• Registration Current

  Yes

  No

  N/A

• Driver Vehicle Inspection Report Completed for previous day

  Yes

  No

  N/A

• Drivers Medical Certification on file

  Yes

  No

  N/A

• Truck cab clean and neat

  Yes

  No

  N/A

• Fire Extinguisher inspected

  Yes

  No

  N/A

• Set of Three Emergency Triangles in vehicle

  Yes

  No

  N/A

Pick up Truck

• Inspection Current

  Yes

  No

  N/A

• Registration Current

  Yes

  No

  N/A

• Driver Vehicle Inspection completed for previous day

  Yes

  No

  N/A

• Cab clean and neat

  Yes

  No

  N/A

• Fire Extinguisher inspected

  Yes

  No

  N/A

Personnel

• Employee's trained

  Yes

  No

  N/A

• Employee's in proper High-Vis apparel

  Yes

  No

  N/A

• Hard Hats

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Proper foot wear

  Yes

  No

  N/A

• Add signature

  Sign

• Add media

  Media