COLUMBUS SITE AUDIT FORM
Submission Date
*
/
Month
/
Day
Year
1
Arrival Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Supervisor
*
First Name
Last Name
Supervisor Email
*
example@example.com
Client Name
*
Site Address
*
Driver Name
*
Partner Name
*
Vehicle Number
*
GPS is in place and zip tied
Arrow board number
Arrow board inspected?
*
YES
NO
N/A
Arrow board photo
Photo of site
*
Photo of site
Photo of site
Photo of site
Gas card in vehicle?
*
YES
NO
Cooler in vehicle?
*
YES
NO
N/A
Vehicle tires in good condition?
*
YES
NO
Advance warning signs present and proper distance?
*
YES
NO
Transition proper length and cone spacing good?
*
YES
NO
N/A
Buffer space proper length and cone spacing good?
*
YES
NO
N/A
Downstream taper proper length and cones space good?
*
YES
NO
N/A
Equipment set up and take down process:
*
Option 1
Option 2
Option 3
Pre-Job done
*
YES
NO
Did crew sign client pre-job briefing?
*
YES
NO
N/A
Company vehicle parked properly and coned off?
*
YES
NO
Is this an after hours or night job?
*
YES
NO
Proper illumination if needed?
*
YES
NO
N/A
Flaggers in correct position?
*
YES
NO
Paddles being used properly?
*
YES
NO
N/A
Are employees wearing proper work clothing?
*
YES
NO
Are employees wearing proper PPE: vest, hard hat, leggings, safety glasses, steel toe boots, and whistles?
*
If you answered "NO" to any question, what steps did you take to correct the problem?
What did you improve? What did you coach?
*
Did you collect ALL paperwork? (time sheets, pre jobs, vacation request, ect.)
*
YES
NO
N/A
End Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: