Chain Saw Operator Field Evaluation Form
Agency Address:
Name:
Date:
Training Location:
Phone:
Email:
Previous Certification? Yes_____ No _____ Level____________ Agency/Unit_____________________ Year__________
Note to Evaluator: A scale of 1 through 5 will be used to identify proficiency in each area:
1 = Weak, 2 = Poor, 3 = Satisfactory, 4 = Very Good, 5 = Outstanding.
0 or N/A means student was not evaluated in area or Not Applicable. All blanks must be filled in.
Any safety violations will result in automatic failure.
NO SAFETY EQUIPMENT SCORE
CHAIN SAW USE
SCORE
HAZARD ANALYSIS
YES
Hard Hat
Chain Saw & Axe Condition
Top
Eye Protection
Starting Procedure
Widow Makers
Hearing Protection
Throttle Lock Use
Bark
Long Sleeved Shirt
Correct Body Position
Leaners
Gloves
Thumb Placement
Hang-ups
Boots
Bar Tip Use - general
Determine Soundness & Lean(s)
Chaps
Boring - specific
Snag/Green Tree Hazards
Axe (3-5 lb)
Chain Brake Use
Root Wads/Loose Logs
Wedges (appropriate)
Foot Travel with Chain Saw
Wind
Approved fuel/oil container
Chain Saw Tool Kit
Spring Poles
Field Chain Sharpening
Disease/Fungus
NOTE: Any safety item deficiency
Other (list)
Other (list)
will result in automatic failure.
SCORE
LIMBING & BRUSHING
SCORE
BUCKING
Overhead & Ground Hazard Analysis
Overhead & Ground Hazard Analysis
Brief Swamper
Escape Route
Control Cutting Area
Bind / Tension-Compression Analysis
Swamps Out Work Area
Swamps Out Work Area
Escape Route
Thumb Placement
Body Positioning
Use of Wedge / Pie Cut
Thumb Placement
Cut Sequence
Use of Bar Tip
Kerf Observation
Avoids Over / Under Reaching
Release Cut Movement
Power-head below Shoulder Height
Multiple Bind Situations
Limb Removal Sequence
Drop Cutting
Spring Poles-Tension/Compression Analysis
Spring Poles-Tension/Compression Analysis
Avoids Kickback
Avoids Kickback
Wedging Procedure
FWS Form 3-2413
11/10
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