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Concrete Trunk Pre-Pump Checklist
Archive Document – DO NOT DISCARD
Job Name:*
Job Name:*
Job Number:*
Job Number:*
Date:*
Fecha:*
Contractor requesting Pump truck:
*
Date of Pour :
*
Contractor Providing Pump truck:
*
Location of Pour :
*
Documentation :
Valid pump truck certification with all repairs completed.
Written verification From pump truck pwner that maintenance has been performed pursuant to manufacturer's recommendations
Written verification of operator's qualifications specific to make and model of pump truck
Verification of current , valid insurance
Complite detailed, written pre-task planning with operator and foreman involved in pour. items to be considered on the pre-task plan
Start & finish times for all pours.
Communication plan
Protective measures for workes, the environment, and the public
Weather Conditions
Pump truck set-up locations, with swing path,travel plan and distance
Pre-Mobilization :
Dpr Superintendent and requesting pump truck contractor perform site walk. Review, at minimum
Condition Of asphait, concrete, soil,etc. Where pump truck will be set-up 7 operating
Location Of overhead electrical lines
Rated Line Voltage.
Kv
Distance of lift to lines .
ft.(must be > 17')
Lines Energized
Yes
No
If Yes, Contact DPR EHS. if no, contact owner and ground lines.
Person designated to observe line clearance for operation
Pump truck set-up loactions, With swing path, travel plan and distance
Distance to neighboring buildings,roadways,walkways,trenches,variations,in soil stability, etc
Pump-truck contractor to provide.
Gross capacity of pump truck & verification of concrete mix design to be used
Maximum radius :
Minimum Boom Angle.
Maximum Boom Length :
Building height.
Location Of Washout .
Mobilization - Continuous throughout Operation :
Site specific safety orientation completed for pump operator and/or/pump crew
Documentation of pump truck Pre-task plan and Boom Inspection
A copy of the manufacturers Operating Manual is on the pump truck
Conduct A safety meeting, covering at least
Pre-task plan
Weather Conditions
Evacuation Plan
Priming Procedures
verify & review means of communication
Safety precuations working around the pump truck & hose operations
Location of emergency stop switch on pump truck
Public Protection
Outriggers must be fully extended,pads level, on solid bearing, and pinned.
Retracting outriggers without a signal man is prohibited
Barricading in place to prevent access to hopper area of pump truck .
Should lifting or hoisting of materials(s) will be needed, additional equipoment must be available (the boom of the pump cannot be used for hoisting materials) .
Traffic control measure in place ,as applicable
Hoses are in good condition & additional hose is available, specific to pour requirements .
Signal Man(if Applicable): .
Ensure these are place :
Hard hats
Fall Protection(harnesses, lanyards as applicable)
PPE (safety glasses, gloves, vests, dust masks, protective boots, face shields, knee pads, etc as applicable for scope of work).
DPR superintendent/EHS Signature:
Clear signature
Date :
Contractor Supervisor Signature:
Clear signature
Date :
Pump Truck Operator Signature:
Clear signature
Date :
