ZeroDay Pre-Task Card

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Weather

Conditions

Temperature

Pre-Task Checklist

• PPE

• Signs/Cones Placed

• Wheels Chocked

• Stretch/ Warm-Up

• Property Damage

• Customer Contacted

• Work Orders

• Pre-Task Card Review

Task

Recognized Hazards (Check all that apply)

• Pedestrian/Vehicle Traffic

• Material Handling

• Job Access

• Co Vehicle Placement

• Sprinkler Systems

• Propane Tanks

• Battery Corrosion

• Energized Electric

• Exposed Wiring

• Faulty Grounding

• Slip/Trip/Fall Hazard

• Pinch Point/Caught Between

• Excessive Noise

• Eye Injury

• Other:

Hazard Protection

• Hearing Protection

• Eye Protection

• Hard Hat/Bump Cap

• Electrical Hazards Noted/Labeled

• Trip Hazards Noted/Labeled

• Equipment Inspectin

• Tool Inspection

• Other:

• Discuss Yesterday's Incidents?

  Yes

  No

  N/A

• Site Safety Orientation Complete?

  Yes

  No

  N/A

• Task Scope Understood?

  Yes

  No

  N/A

Post-Job Checklist

• Waste/Remaining Product Removed

• Tools Returned to Vehicle

• On-Site Equipment Secured

• Truck/Trailer/Equipment Secured

Other Comments: