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47 A P P E N D I X C Behavior Checklists Behavioral Checklist Contributed by Roy Nester at J. J. Taylor, 48 Behavioral Checklists Contributed by Marathon Ashland, 49 Behavioral Checklists Contributed by Praxair, 52 Self-Management Checklist Used in Hickman and Geller (2003b), 54 Self-Management Checklists Contributed by Anonymous Respondent, 54
48 J.J. Taylor Distributing Florida, Inc. Fort Myers Branch Delivery Drive With Checklist Date: ______________, ______ Delivery Person: ____________________________ Supervisor: ________________________________ Appearance: Merchandising: Clean full uniform Refilled and Build new displays Clean dark steel toe shoes Rotation of product in display and shelf Shaved and clean cut Rotation of product in cooler Rotation of product in backroom Customer Service: Used of POS as required Greeted customer upon entering business Pricing as required in a cordial manner Resolved issues, if any, with customer Safety: Reviewed order prior to start unloading Performed full pre/post trip inspection Stacked beer in designated area Used stoppers on raillift Tied down load during the day Absenteeism/tardiness: Secured damages in separate pallet Showed up on time Obeyed traffic signals No excessive tardiness/absenteeism Maintained posted speed limits in previous 6 weeks Park properly in customers premises Proper use of handcarts Other: Pallet jack certified Maintain clean tractor cab Stacked down product in bays/pallets Cleaned trailer at end of day Used safe box in tractor for cash Settlement: Pallet truck inspection form T-com everyday Print copies of valid and voided invoices Explain all overages/shortages, product/money Driver Signature: __________________________ Date: ____________________ Behavioral Checklist Contributed by Roy Nester at J. J. Taylor
49 Behavioral Checklists Contributed by Marathon Ashland
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52 Behavioral Checklists Contributed by Praxair
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54 Self-Management Checklist Used in Hickman and Geller (2003b) Self-Management Checklists Contributed by Anonymous Respondent Completed after starting your shift for the day Date:_________ Driver #________________ _____% of the time I drove today without Overspeeding (please estimate) #_____of times I had an Extreme Braking incident today while driving (please estimate) Comments:_____________________________________ ______________________________________________ ______________________________________________ ______________________________________________ While working today I did the following: Always Not Always 1. Wore my seat belt 2. Used three-point stance on tractor and trailer 3. Drove the posted speed limit or less on all roads 4. Used G.O.A.L. when backing or maneuvering close to fixed objects 5. Your ARB choiceâ¦â¦â¦â¦ 6. Your ARB choiceâ¦â¦â¦â¦ Totals Employee Signature: _________________________________ Date ____/____/_______ While working today I did the following: Always Not Always 7. Wore my seat belt 8. Used three-point stance on tractor and trailer 9. Used handrail on all steps 10. Wore all required PPE (gloves, Nomex, hardhat, safety shoes, etc..) 11. Wrote up hazardous lease reports for all hazards I discovered 12. Drove the posted speed limit or less on all roads 13. Inspected truck & trailer when stopped to load, unload or take break 14. Drove slowly through cattle guards or near fixed objects 15. Used G.O.A.L. when backing or maneuvering close to fixed objects 16. Scanned intersections for cross traffic as I approached them 17. Checked that valves were in proper position and hoses were securely connected before operating pump 18. Checked liquid level in tanks before pumping into them 19. Stay by pump controls and level indicator during the entire loading process 20. Worked oil per the procedures in crude oil manual 21. Wrote up mechanical defects and safety defects on the equipment I operated 22. Turned my face away from tank hatches when first opening them 23. Watched for tripping hazards, eliminated those I could and wrote up remainder 24. Avoided answering phone or radio when I was in the middle of driving, loading or unloading 25. Started procedure or task over again if I was distracted 26. Gave right of way to all other vehicles on roads 27. Closed off valves and stowed hoses when leaving unloading/loading locations 28. Observed co-workers operating near me and coached them if I noticed a possible shortcut or missed procedure 29. Securely tied open gates that I drove through before entering 30. Positioned my truck to avoid backing whenever possible 31. Circled truck to make sure valves, hoses, fittings, tools, etc. were properly stored before driving away from loading or unloading site Totals Employee Signature: ___________________________________ Date ____/____/_______
