Flagger Inspection Date *Time *Hour-000102030405060708091011121314151617181920212223Minute-00153045Customer *GPCUTECPikeService ElectricLINETECInnerLinerOtherCustomer NameProvide Customer NameLOCATION OF WORK SITECityStateFOREMAN/SUPERVISOR *Flagger Non-driver *Police OfficerSafety Check *Is the Flagger safe? Please describe the safety parameters of Traffic Troopers Flagger at the work site by checking the appropriate boxes.Proper Uniform (hard hat, safety vest, steel toe boots)Flagger is situated in a planned escape routeVisible to approaching trafficSTOP/SLOW paddleVehicle parked off the road, away from stationSetup *Is the Temporary Traffic Control Plan setup properly? Please describe the proper setup by checking the appropriate boxes.TA10 DOT proper setupTA33 DOT proper setupCommunication *Has the Flagger communicated with Foreman regarding the temporary traffic control plan? Please describe based on your communication with the foreman and/or Flagger at the work site by checking the appropriate boxes.Safety BriefingSupervisorCoworkersEngagement *Is the Flagger following company policy? Please describe the activity of Traffic Troopers Flagger at the work site by checking the appropriate boxes.Not mingled with the work crew or motoristsNot on phoneMingled with the work crew or motoristsOn phoneEQUIPMENT *Does the Flagger have the appropriate equipment? Please describe the equipment on the truck by checking the appropriate boxes.STOP/SLOW paddleFlashlightWalkie TalkiesProper amount of conesProper amount of barrelsDelineatorsStep stoolNot enough conesNot enough barrelsFile UploadDrag and Drop (or) Choose FilesNOTES/COMMENTSPlease include additional information or comments if necessary.VerificationEnter any two-digit number *Submit Report