SE-Ops TOOL INSPECTION

TOOL INSPECTION FORM
Inspection Month*
Person Conducting Inspection
First NameLast Name
Tech #:*
Tech Email:*
example@example.com
*Note: Lost or missing tools should be listed as failed and replace accordingly.
- General Tools -
Block & Tackle*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
1
Cable Caddy*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cable Grip*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Chainsaw*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Ditty Bag (2)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill, Cordless 3/8"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill, Electric 3/8"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Extention Cord*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Plug Adaptor*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Flashlight*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Gaffs/Climbers*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Generstor, Gas Powered*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Glow Rods (2)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Ground Rod Driver*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
What Ladders do you have?*
TallMediumStep
Which Tall Ladder do you have?*
32ft.28ft.
Ladder, 32'*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Ladder, 28'*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Ladder, Step*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Spotlight*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool Bucket*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool Kit, Fiber Restoration (2)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool Pouch w/Belt*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Test Tools -
Analyzer*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Frequency Counter*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Locator, Cable*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which Signal Level Meter do you have?*
VeEXJDSUOther
Model # of you SLM:
Meter, SLM*
PassFailN/A
Comments:*
Date Tool was Calibrated:
MonthDayYear
Date
Meter, Clamp-on AMP*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which CLI gear do you have?*
EffigisSluthSniffer SentinelTrilithic Searcher +N/A
Meter, CLI*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Meter, HSD*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Meter, Power*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Meter, Sweep*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Meter, Volt/Ohm*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
OTDR*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
TDR*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Test Set, Telephone*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which Test Set do you have?
Test Set, TV*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tester, Telephone Line*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tester, Telephone Toner*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cable Toner*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Construction Tools -
Cutters, Bolt*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill, Electric 1/2"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill, Gas*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Hoist, Chain*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Mullen Bender*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Rollers, Cable*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
How Many Cable Rollers do you have?
Stick, Lay-Up*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Stick, Measuring*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, Loop Forming*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
90*Block / Corner Block*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cable Shoot*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cable Lasher C/J*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cable Jig / Straightener Tool*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Pulling Grip*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Pole Sling*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Personal Protective Equipment -
Apron/Gloves Chemical Resistant*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Boots, Work (6" lace-up; 1/2 Heel; Shank; Toe)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Chocks, Appropriate Size*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cones, 6 for BBT1,2,3 / 13 for BBT 4,5*
PassFailN/A
Comments:*
How many cones do you currently have?
Date Tool was replaced:
MonthDayYear
Date
Fire Extingisher - 2.5# for Pickups, 8# for Buckets*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which Fire Extinguisher do you have?*
ABC - 2Lb; ABC - 8Lb, ABC - 10Lb
Glasses/Goggles/Face Shield (ANSI Z87.1)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Gloves, 3" Gauntlet*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Gloves, Insulated W/Cover (Required Class)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Hat, Hard (Class B or E, Type I or II)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Signs, Workers Ahead and/or Triangle Reflectors*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
System, Full Fall Arrest (Harness)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
System, Full Fall Arrest (Lanyard)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
System, Positioning (Body Belt/Safety Strap or Super Squeeze Belt)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Vest, Reflective 360 (Class II)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Foreign Voltage Detector*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Mobile Communication Device (Company issued Phone)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Hand Tools -
Awl*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cleaner, Center Conductor*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Crimpers, Telephone (RJ12)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Phone Wire Pick*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Punch Down Tool*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Needle Nose with Crimper*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cutters, Cable*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cutters, Diagonal*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill Bit, Brace*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill Bits, Installation*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill Bits, Pole*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Driver Bit, 1/4"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Hammer, #2*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Hammer, Claw*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Knife, Splicing*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Knife, Utility*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Scissors & Holder*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 1/2"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 1/4"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 3/16"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 3/8"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 5/16"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Nut Driver, 7/16"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Pliers, 9"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Pliers, Needle-Nose*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Pliers, Pump*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Propane Torch Head*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Saw, Bow*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Saw, Hack*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which Screw Drivers do you have?*
IndividualAll In OneBoth
Screw Driver, Phillips (Lg/Sm)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Screw Driver, Slot Head (Lg/Sm)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Screw Driver, All in One*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Shovel, Sharp Shooter*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Shovel, Spade*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tape, Fish*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Which Cable Prep Tool do you have?*
RG-6 (Yellow)RG-11 (Blue)Combo (Blue)
Tool, Cable Prep*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, Crimper/Compression*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, Drop Burying*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, Terminating*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, Trap*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tool, VCR*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, Can*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tweeker*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Vise Grips*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, 10" Crescent*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, 12" Crescent*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, 3/8" Open End*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, 7/16" Open End*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, 1/2" Open End*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Wrench, Bell Lineman*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Test Probe*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Other -
Rain Gear*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Uniform*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Cooler, Water (3-5 gallon)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Gas Can*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, Channel Lock*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, ML 1023*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, NX-7*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, Brass "P"*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, Highfield Ped Lock (Red)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Key, Supra Lockbox (6225) (Coke Key)*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
GPS Device*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
PC or Laptop for Vehicle*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
- Security Tools -
Precision Screwdrivers*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Hemostat*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Drill Bit Kit*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Glass Break Tester*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Flex Bit*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Tape Measure*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Level*
PassFailN/A
Comments:*
Date Tool was replaced:
MonthDayYear
Date
Overall Comments
Please add additional pictures here
Cancelof
Report Card Scores:
100 = 5 99 & 90 = 4 89 & 80 = 3 79 & 70 = 2 69 or less = 1
Total Score:
70 or less is failing
By signing below, I acknowlage that I have received the tool(s) above and acknowledge that I may be required to reimburse Company for replacement cost of any item(s) lost or damaged from neglect or misuse.
Signature*
Signature:
Clear
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TOOL INSPECTION FORM