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Field survey checklist

This generic field survey checklist ensures that all observations during inspections are documented efficiently.

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Field survey checklist

Audit

1. Driving Observation: Does Driver...

a. And all occupants wear seatbelts?

b. Obey posted speed limits?

c. Maintain adequate following distance?

d. Slow down gradually when approaching red lights and stop signs?

e. Make a full stop at all stop signs?

f. Drive with caution in congested/construction zones?

g. Avoid excessive and unnecessary lane changes?

h. Blend smoothly with merging traffic?

i. Have loads secured properly?

j. Maintain proper speeds for conditions (i.e. rain, pulling trailer/load)

k. Have trailer properly hooked up and tail lights operational?

l. Utilize strobe lights upon entering/leaving worksite?

Notes:

2. Boating Operations: Does operator/crew:

a. Wear approved Life Vests at all times?

b. Have Boat Inspection/Orientation filled out and on hand?

c. Have all safety equipment on board?

d. Operate boat safely and consistent with policies?

e. Have current registration sticker and registration?

f. Water or fluids on board?

g. Load/Unload boat safely?

h. Maintain attention to the surrounding and to FDOT Employees?

3. If Flagging Operation Observed: Does Crew...

a. Maintain attention to oncoming traffic at all times?

b. Utilize strobe lights on vehicle?

c. Use proper lifting techniques for loading/unloading?

d. Set up/pick up flagging operation in proper sequence?

e. Have proper and valid certifications?

f. Place temporary traffic control devices at proper spacing and according to specifications?

g. Position flaggers properly?

h. Stay behind positive protection when outside of vehicle and idle?

i. Park vehicle behind position protection or as far from travel as possible?

j. Utilize light towers for night flagging?

k. Utilize reflective stop/slow for night flagging?

l. Flag traffic correctly and efficiently?

m. Have traffic properly and safely controlled?

Notes:

4. If Lane Closure Operations Observed, Does Crew...

a. Maintain attention to oncoming traffic at all times?

b. Utilize strobe lights on vehicle?

c. Utilize proper lifting techniques for loading/unloading?

d. Set up/pick up lane closure operations in proper sequence?

e. Place Temporary Traffic Control Devices at proper spacing and according to specifications?

f. Stay behind positive protection when outside of vehicle and idle?

g. Park vehicle behind positive protection or as far from travel lane as possible?

h. Maintain cones upright?

Notes:

5. If Light/Flag Service Operation Observed: Does Crew...

a. Maintain attention to oncoming traffic at all times?

b. Utilize strobe lights on vehicles?

c. Utilize proper lifting techniques for loading/unloading?

d. Perform service behind positive protection?

e. Remove device away from travel lane before servicing?

f. Utilize fall protection plan and CAZ when servicing lights accessible from the working surface of a bridge for lights on a leading edge?

g. Use ladders safely and according to safety policy?

h. Remove signs from the wall before servicing when located on a leading edge?

i. Utilize PPE fall protection when servicing lights/flags on signs located on a leading edge?

j. Park vehicle behind positive protection or as far from travel lane as possible?

Notes:

6. If Delivery/Pickup Operation is Observed, Does Crew...

a. Have load properly secured?

b. Maintain attention to oncoming traffic at all times?

c. Utilize strobe lights on vehicles?

d. Use proper lifting techniques?

e. Deliver/pick up proper equipment?

f. Unload/load behind positive protection or a far from the travel lane as possible?

g. Have trailer properly hooked up to vehicle?

Notes:

7. If Sign Installation/Removal is Observed: Does Crew...

a. Maintain attention to oncoming traffic at all times?

b. Utilize strobe lights on vehicles?

c. Utilize proper lifting techniques for loading/unloading?

d. Install sign to proper FDOT offset from travel lane?

e. Install sign according to plans and specifications?

f. Pay attention to utility locates during installation?

g. Excavate in a safe manner?

h. Utilize PPE fall protection when installing signs on a leading edge?

i. Park or work behind positive protection or as far from travel lane as possible?

Notes:

8. If Installation/Repair or Removal of Attenuator is Observed, Does Crew...

a. Maintain attention to oncoming traffic at all times?

b. Utilize strobe lights on vehicle?

c. Utilize proper lifting techniques for loading/unloading?

d. Properly secure load?

e. Utilize proper hoisting techniques?

f. Utilize power tools with frayed or cut cords?

g. Wear proper eye protection when drilling holes or grinding or cutting bolts?

h. Utilize proper nuts/bolts/epoxy?

i. Park truck and/or trailer between them and oncoming traffic?

j. Maintain sage distance from objects that are hoisted?

k. Utilizes additional safety measures (i.e. TMA, lane closure) if worksite is unsafe distance from travel lanes?

l. Utilize proper respirator protection during drilling concrete if appropriate?

Notes:

General Comments

Comments:

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.