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(855) 920-8722

Audit Forms

Select Form

Equipment Audit Form

Safety Audit Form

Pre-Op Equipment Inspection Form

Pre-Op Vehicle Inspection

Operators Daily Visual Inspection

Equipment Audit Form

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Equipment Audit Form

Select Location

Conducted by: *

Email *

Date *

Equipment # *

Operator *

General Safety

1. Task Training (Operator) *

Comments/Corrective Action

2. Daily Equipment Inspection Completed and Documented *

Comments/Corrective Action

3. Operator's Manual Available in Cab of Equipment *

Comments/Corrective Action

4. Fire Extinguisher Available and Properly Tagged *

Comments/Corrective Action

5. First Aid Kit Available and properly stocked *

Comments/Corrective Action

6. Lighted Buggy Whip and/or Beacon *

Comments/Corrective Action

7. LOTO Procedures in Place Operator Understands When and Where to Use. *

Comments/Corrective Action

From The Ground

1. Tires, Wheels, Lug Nuts, Stem, Caps *

Comments/Corrective Action

2. Bucket, Cutting Edge (if equipped) *

Comments/Corrective Action

3. All Hydraulic Cylinders *

Comments/Corrective Action

4. Equip. Frame/Arms *

Comments/Corrective Action

5. Transmission, Transfer Case *

Comments/Corrective Action

6. Fuel Tank *

Comments/Corrective Action

7. Hydraulic Tank *

Comments/Corrective Action

8. Air Tank *

Comments/Corrective Action

9. Axles *

Comments/Corrective Action

10. Differential *

Comments/Corrective Action

11. Lights (Front, Rear, Work) *

Comments/Corrective Action

12. Battery Cables/Terminals *

Comments/Corrective Action

13. Chain Drive/Adjustment (if equipped) *

Comments/Corrective Action

14. Hi-Rail Gear (if equipped) *

Comments/Corrective Action

15. Equip. Components Greased Regularly (grease fittings) *

Comments/Corrective Action

Engine Compartment

1. Engine Oil *

Comments/Corrective Action

2. Engine Coolant *

Comments/Corrective Action

3. Radiator *

Comments/Corrective Action

4. All Hoses *

Comments/Corrective Action

5. Fuel Filter/Water Separator *

Comments/Corrective Action

6. All Belts *

Comments/Corrective Action

7. Air Filters *

Comments/Corrective Action

8. Overall Engine Compartment *

Comments/Corrective Action

Outside the Cab

1. Steps and Handrails *

Comments/Corrective Action

2. Roll Over Protection (ROPS) *

Comments/Corrective Action

3. Windshield/Windows *

Comments/Corrective Action

4. Windshield Wipers/Washers *

Comments/Corrective Action

5. Doors/Door Latches *

Comments/Corrective Action

6. Overall Outside condition *

Comments/Corrective Action

Inside the Cab

1. Seat/Seatbelts and Mounting *

Comments/Corrective Action

2. Horn, Backup Alarm, Lights *

Comments/Corrective Action

3. Mirrors Clean and Properly Adjusted *

Comments/Corrective Action

4. Cab Air Filter (if equipped) *

Comments/Corrective Action

5. Gauges, Indicators, Switches Controls *

Comments/Corrective Action

6. Housekeeping *

Comments/Corrective Action

7. Overall Cab Interior *

Comments/Corrective Action

Additional Comments

Safety Audit Form

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Safety Audit Form

Select Location

Conducted by: *

Email *

Date *

Crew *

Foreman *

Location *

Job Briefing/On Shift Inspection

1. Job Briefing filled out *

Comments/Corrective Action

2. On Shift Inspection completed (book filled out) *

Comments/Corrective Action

3. Work assignments reviewed *

Comments/Corrective Action

4. Work procedures discussed *

Comments/Corrective Action

5. Tools/Equipment reviewed *

Comments/Corrective Action

6. Job Hazards discussed *

Comments/Corrective Action

7. First Aid & CPR trained person on site *

Comments/Corrective Action

8. On/Off Track Safety Procedures in place (red flags, etc.) *

Comments/Corrective Action

9. Lockout/Tagout Procedures in place if necessary *

Comments/Corrective Action

10. Personal locks available *

Comments/Corrective Action

PPE

1. Hard hats *

Comments/Corrective Action

2. Safety glasses *

Comments/Corrective Action

3. Safety toe boots/metatarsals *

Comments/Corrective Action

4. Safety vests / Shirts *

Comments/Corrective Action

5. Gloves *

Comments/Corrective Action

6. Hearing Protection available (being used) *

Comments/Corrective Action

Additional PPE (As necessary)

1. Face shields/screens *

Comments/Corrective Action

2. Leg Protectors (Cutting) *

Comments/Corrective Action

3. Arm sleeves *

Comments/Corrective Action

HazCom

1. Chemicals properly stored *

Comments/Corrective Action

2. Approved containers *

Comments/Corrective Action

3. Containers properly labeled *

Comments/Corrective Action

4. SDS's available *

Comments/Corrective Action

Power Tools

1. Power Unit *

Comments/Corrective Action

2. Rail Saw *

Comments/Corrective Action

3. Rail Drill *

Comments/Corrective Action

4. Impact Wrench *

Comments/Corrective Action

5. Spiker *

Comments/Corrective Action

6. Spike Puller *

Comments/Corrective Action

7. Tie Drill *

Comments/Corrective Action

8. Hand Tamper *

Comments/Corrective Action

9. Jackhammer *

Comments/Corrective Action

10. Grinder *

Comments/Corrective Action

11. Leafblower *

Comments/Corrective Action

12. Weed eater *

Comments/Corrective Action

13. Hydraulic Hoses *

Comments/Corrective Action

Hand Tools

1. Spike Mauls *

Comments/Corrective Action

2. Sledge Hammers *

Comments/Corrective Action

3. Claw Bars *

Comments/Corrective Action

4. Lining Bars *

Comments/Corrective Action

5. Spike Lifters *

Comments/Corrective Action

6. Bolt Punches *

Comments/Corrective Action

7. Rail Wedges *

Comments/Corrective Action

8. Track Wrenches *

Comments/Corrective Action

9. Tie Tongs *

Comments/Corrective Action

10. Picks *

Comments/Corrective Action

11. Shovels *

Comments/Corrective Action

12. Drift pins *

Comments/Corrective Action

13. Rail Dogs (equip.) *

Comments/Corrective Action

14. Crescent wrenches *

Comments/Corrective Action

15. Track Jacks *

Comments/Corrective Action

Welding/Cutting

1. Welding Hoods *

Comments/Corrective Action

2. Face Shields *

Comments/Corrective Action

3. Goggles *

Comments/Corrective Action

4. Respirators *

Comments/Corrective Action

5. Oxygen/Acetylene properly stored *

Comments/Corrective Action

6. Gauges in proper working condition *

Comments/Corrective Action

7. Welding/cutting shields in place *

Comments/Corrective Action

Electrical

1. Trigger locks removed *

Comments/Corrective Action

2. Electrical inspection completed (properly coded) *

Comments/Corrective Action

3. Extension cords in good condition *

Comments/Corrective Action

4. Generator *

Comments/Corrective Action

Vehicle/Equipment #

1. Daily Pre-op completed *

Comments/Corrective Action

2. Seat Belts in use *

Comments/Corrective Action

3. Fire Extinguisher available and properly tagged *

Comments/Corrective Action

4. First Aid Kit available *

Comments/Corrective Action

5. Horn/backup alarm *

Comments/Corrective Action

6. Lights/turn signals working *

Comments/Corrective Action

7. Windows in good condition *

Comments/Corrective Action

8. Lighted buggy whip *

Comments/Corrective Action

9. Doors/latches working properly *

Comments/Corrective Action

10. Brakes functioning properly *

Comments/Corrective Action

11. Tires in good condition *

Comments/Corrective Action

12. Wheels chocked. *

Comments/Corrective Action

13. Proper housekeeping *

Comments/Corrective Action

14. Overall condition *

Comments/Corrective Action

Tool Trailer/Trailer #

1. Tools/Equipment properly stored *

Comments/Corrective Action

2. First Aid Kit available *

Comments/Corrective Action

3. Fire Extinguisher available and properly tagged *

Comments/Corrective Action

4. Chemicals properly stored *

Comments/Corrective Action

5. Approved containers/ properly labeled *

Comments/Corrective Action

6. Drinking water available *

Comments/Corrective Action

7. Doors/latches working properly *

Comments/Corrective Action

8. Lights/turn signals working *

Comments/Corrective Action

9. Tires in good condition *

Comments/Corrective Action

10. Hitch cables, plugs, chains *

Comments/Corrective Action

11. Proper housekeeping *

Comments/Corrective Action

12. Overall trailer condition *

Comments/Corrective Action

Additional Comments

Pre-Op Equipment Inspection Form

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Equipment #

Hours

Location

Inspected By:

Date:

Status

S= Satisfactory
D= Deficient
N/A= Not Applicable

Comments

Pre-Op Vehicle Inspection

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Vehicle #:

Trailer #:

Mileage:

Driver:

Location:

Date:

Comments

Operators Daily Visual Inspection

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Operators Daily Visual Inspection

Select Location

Name: *

Unit #:

Job #:

Date *

Hours:

360° Circle of Safety Completed? *

Safety Issue Notes:

Supervisor Notified? *

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