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Water CheckHst #4 <br /> A. <br /> [Da�te — S� �� LOCation 31ZZ. k�ewE'� Crew Lead <br /> B. <br /> Flaggers Names ES or N Briefed by <br /> (YES or NO) <br /> X4 <br /> Flagger Briefing: <br /> Job Tasks: Flagger Responsibilities, Emergency Signals, 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 Equipment # Location Inspection Comment, <br /> // Completed? <br /> It/ /� V <br /> J0/7-5 a <br /> -D Arilerf 1701 ly <br /> D. Checklist #4 - Routine Part 1 <br /> YES YES NO <br /> 1. Make site visit before starting work 5. In water work <br /> 2. Define activity, scope, and limits Stop work <br /> 3. Review Part 1 BMPs, m Contact environmental staff for <br /> Permit needed review <br /> Evaluate using detailed checklist <br /> ® Equipment maintenance 1, 2, and/or 3 and routine <br /> Disturbed soil checklist <br /> Waste material removed <br /> Spill kit 6. Location <br /> Part 2 BMPs needed 1 <br /> Use checklist#3 and routine Z <br /> checklist 3 <br /> 4. Is environmental staff required? 4 <br /> NO - continue maintenance 5 <br /> YES - contact environmental staff for <br /> review <br /> C:\Users\lhusby\Desktop\Checklist4_V%7ater.doc <br />