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Observers Ride Along Checklist
This ride along checklist has been designed to assist the observer in conducting a review of the new and returning employees work skills and understanding of the safety protocols. Observers are to encourage dialogue and have the employee explain how he/she does their job, the employee should be training the observer on how to do the job safely.
Observer Name
*
Type in your name above
Drivers Name
*
Type in the name of the employee you are observing above
Start Time
*
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Month
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Day
Year
Observation start date & time
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Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Rating System Information
Level 1
Demonstrated Tasks some of the time (i.e. Proper use of Raven less than 75% of the time)
Level 2
Demonstrated Tasks most of the time (i.e. Used Chock blocks 75-99% of the time)
Level 3
Demonstrated Tasks all of the time (i.e. Wore proper PPE 100% of the time)
Additional Information
Note
Additional Site Specific PPE, Training and Orientation may be needed and must be adhered to at all times. Example: Oilfield Orientation, H2S Alive Training and Personal Gas Monitors Training. Construction or Mine site, site specific training. In these circumstances, the ride along attendee will stay in the truck on these sites unless the site specific objectives are met.
Personal Protective Equipment (PPE)
*
Level 3
Level 2
Level 1
N/A
Flame Resistant Clothing (FRC) in good condition and properly worn
Hi Visibility Vesting available or incorporated into FRC clothing
Safety Glasses available and in good condition
Approved CSA Footwear (green triangle) worn
Approved traction aids on hand and in good condition
Hard Hat available and in good condition, in date as per manufactures instructions
Appropriate hand protection available and in good condition
Documentation
*
Level 3
Level 2
Level 1
N/A
PTI Courses up to date such as WHMIS, TDG, Drivers license (proper class)
Job Safety Plan (JSP) complete and with meaningful content
Safety Awareness
*
Level 3
Level 2
Level 1
N/A
Adjusts seat
Adjusts mirrors
Adjusts/wears seatbelt
Checks truck documents/Cab check List
Understands the Three Rights, (Right to: Know, Participate, Refuse)
Near Miss and Incident Reporting, does the driver understand the process
Performs Pre / Post Trip Inspection DVIR (observer to participate)
Performs the daily off truck remote emergency shut down test (ISC Full closure )
Review Location of, On Truck Emergency Shut Offs / Positive Air shut offs
First Aid Kit: Driver knows location, and is accessible
Demonstrates Pump Greasing
Monthly Truck Emergency Shutdown System test form completed (Fully understands Meter Creep )
Fire Extinguisher: Knows location, checks date and charge
Demonstrates Proper garaging procedures along with reintroducing Vapour/Liquid afterwards
Demonstrates proper use of three points of contact when entering and exiting truck
Technology
*
Level 3
Level 2
Level 1
N/A
Complete start of shift in Raven handheld including verifying download, logging in, and loading a truck in the Raven
Complete a manual Sync
Illustrate how to complete a correction due to choosing wrong truck selected
Complete a delivery
Cancel a delivery
Complete a pumpout
Complete all necessary steps to cancel a delivery due to safety issues
Complete end of shift process including printout of daily trip report
Complete taking a payment by cheque
Complete an Activity for meeting
Demonstrates an understanding of Bar Coding and accurate use of PRV steps
Demonstrates ability to complete tank and Pressure Relief Valve Inspection
Driving Skill Observations
*
Level 3
Level 2
Level 1
N/A
Turning: Driver is observant of surrounding conditions before and during turns
Turn signals used during lane changes and turns
Mirrior use for lane change
Yields Right of Way to pedestrians and vehicles
Drives to Posted Speed Limits
Uses tire chains when required
Uses chock blocks
Walks around truck prior to leaving
Obeys traffic control devices such as stop signs, traffic lights, etc...
Smooth starts and stops ensuring proper stopping distance
Narrow Roadways - Watching on coming Traffic, yielding right of way, confident
Gravel and asphalt surfaces - correct transition from asphalt to gravel
Demonstrates proper Railroad crossing procedure
Proper use of clutch
Proper use/selection of gears
Proper use of brakes
Performs regular traffic checks
Two hands used on wheel
Proper speed for road conditions
Maintains safe following conditions
Inclines and declines - Proper selection of gears and use of clutch
Backing
*
Level 3
Level 2
Level 1
N/A
Physical inspection of area prior to backing when view is obstructed
Back into deliver site when possible, (avoids driving in and backing out)
Demonstrates use of mirrors, horn, 4 way flashers, opens window, shuts off radio
Demonstrates proper use of backup camera
Propane Delivery Observations
*
Level 3
Level 2
Level 1
N/A
Observant of hazards at site (changes JSP as required)
PPE worn, Safety Glasses, gloves, FR clothing
Performs a prefill inspection on the tank, demonstrates training received
Positions Bulk Truck in Driveway allowing the best hose pull possible
Performs proper filling procedures, including filling by Bleeder Valve
Is aware his surroundings and controls the filling area
Ensures all valves are closed on truck prior to transit
Loading Procedures at the Bulk Plant
*
Level 3
Level 2
Level 1
N/A
Ensure TDG Placcards are displayed
Hazardous Situations - review shutdown procedures
Loading Procedures review step by step procedures
Load Completion - Securing plant
Safety Check - remove chock blocks and walk around truck
What documentation is required
Location of Training
*
Type in the location of your training
Was feedback provided for all Level 1 selections?
*
Yes
No
Total Number of Calls
*
Enter # of calls
End Time
*
-
Month
-
Day
Year
Observation end date & time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
AM/PM Option
Other Comments
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example@example.com
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Observer Signature
*
Submit Observation
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