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Water Checklist #4 <br />Date /p_gs_Z.L Location I .4o Crew Lead �lr� <br />Flaggers Names Briefed? Briefed by <br />or NO <br />Flagger Briefing: <br />Job Tasks: Flagger Responsibilities, Emergency 5ignals, Flagger Radios, Specific work zone hazards, <br />PPE, Night Lighting, Planned Equipment Movement, Emergency Escape Plans. <br />C. Vehicle Inspection Checklist: <br />Driver's Name <br />Equipment# <br />Location <br />Inspection <br />completed? <br />Comments <br />o)3S <br />o <br />is <br />c// <br />Hee <br />L nS Cr <br />004 <br />Lra nlolls <br />6 <br />✓ <br />D. Checklist #4 - Routine Part 1 <br />YES <br />NO <br />1. Make site visit before starting work <br />✓ <br />2. Define allMty, scope, and limits <br />✓ <br />3. Review Part i BMPs <br />✓ <br />• Permit needed <br />✓ <br />• Equipment maintenance <br />y <br />• Disturbed soil <br />vr <br />. • Wazte material removed <br />✓ <br />SpiN kit <br />• Part 2 aMPs needed <br />✓ <br />• Use checklist #3 and routine <br />cheddist <br />✓ <br />4. is environmental staff required? <br />NO - continue maintenance <br />YES - contact environmental staff for <br />review <br />✓ <br />YES <br />NO <br />5. In waterwork <br />Stop work <br />y <br />• Contact environmental staff for <br />review <br />• EvaLuate using detailed checklist <br />1, 2, and/or 3 and routine <br />checklist <br />6. Location <br />t <br />2 <br />3 <br />4 <br />5 <br />ckm�sryenmkm� vm�a: <br />