ISA Certified Tree Worker Climber Specialist Skills Test Evaluation Form

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IA Certified Tree Worker Climber pecialist kills Test Evaluation Form REQIRED EQIPMENT Hardhat, safety glasses, work boots, climbing Climber brings required equipment and must rope, saddle, handsaw/scabbard, locking meet standard. snaps/carabiners (must be double auto locking carabiners), safety lanyard(s). PRE-CLIMB INPECTION EQIPMENT Climber demonstrates pre-climb inspection of equipment. Evaluator's comment: " demonstrate inspection of equipment." PROPER TIE-IN Climber demonstrated proper tie-in. TYING A FIGRE-8 Climber demonstrates tying a figure-8 in running end. ON ROPE TET Climber demonstrates on rope test for body thrust or secured footlock. A. PRE-CLIMB (TAGING AREA) No points involved. Must have all approved equipment to proceed. Equipment must be arborist grade and must satisfy all applicable OHA, ANI, or CA standards. When using a carabiner without a captive eye, the knot or eye splice shall cinch or be retained in place to prevent side loadimg or accidental opening of the gate. A recognized friction hitch tied for ascent. If unsatisfactory, climber may not continue. Blake's hitch, Distel, chwabisch, or Figure-8 stopper knot tied. 15 Tied in, feet on tree, hands off rope. Must be successful before continuing. KNOT & HITCHE Each knot must be tied correctly on first attempt for a satisfactory Cow hitch with a better half or timber hitch Buntline hitch, anchor hitch, or double fisherman's bend (double fisherman's knot) End-of-line: clove hitch or bowline heet bend or quick hitch ecured footlock ascending knot: Kleimheist or English Prusik Midline knot: clove hitch or butterfly knot Points Deducted ection A: Revised 11/11 Pg. 1 of 4

IA Certified Tree Worker Climber pecialist kills Test Evaluation Form TREE & ITE INPECTION Climber inspects tree and site. Evaluator's comment: " demonstrate inspection of the tree and site." TART TIMING CLIMBING LINE INTALLATION Climber installs climbing rope at a predetermined position. [20-25 feet (6-8 meters) above the ground] B. ROPE THROW for location of utilities and wires. In ground targets. Above ground targets. Tree structure/stability. Time starts on first throw. Climbing rope must be installed in position to allow the climber to safely enter the tree. Five (5) attempts maximum. Throwline permitted. Points Deducted ection B: tart Time: ECRED ENTRY INTO TREE Climber demonstrated secured entry into tree. Evaluator's comment: " demonstrate entry using body-thrust OR secured footlock." A recognized friction hitch tied for ascent. If unsatisfactory, climber may not continue. Blake's hitch, Distel, chwabisch, or Points Deducted ection C: TREE INPECTION Climber demonstrates inspection of tree. Evaluator's comment: " demonstrate inspection of tree." ACEND TO FINAL, PRE-DETERMINED TIE-IN POINT Climber demonstrates ascent to final, predetermined tie-in point. D. ROPE ADVANCEMENT Verbally identify potential hazards (if any). 20 Must be secured at all times. se accepted and safe climbing techniques. The climber may throw rope as many times as necessary, may use pole to set rope, may climb using safety lanyard(s). Points Deducted ection D: Revised 11/11 Pg. 2 of 4

IA Certified Tree Worker Climber pecialist kills Test Evaluation Form FINAL TIE-IN Climber demonstrates final tie-in. Evaluator's comment: " demonstrate final tie-in." E. TIE-IN Climber chooses technique. Remain tied in at all times with lanyard, other end of climbing rope, or second climbing line. Tie in with recognized friction hitch and stopper knot. Blake's hitch, Distel, chwabisch, or Climber must be secured at all times. Failure to do so will result in termination of the exam. TIME LIMIT ON TYING IN Climber demonstrates tying the knot within maximum time allowed. Maximum of 20 minutes to tie-in point. If greater than 20 minutes - Fail exam. (Deduct 2) Points Deducted ection E: FIRT DEIGNATED WORK TATION Climber demonstrates controlled use of climbing rope. HAND CONTACT OF BELL OR FLAG Climber approaches bell OR flag. F. HAND CONTACT TATION Climber should never be in a position to fall (unchecked) greater than 3 feet (0.91 meters). If climber is in a position to fall, he/she should be informed immediately. A second offense will constitute failure. Climber should maintain balanced, controlled, and confident posture. Climber must touch bell OR flag with hand. 15 Points Deducted ection F: 20 Revised 11/11 Pg. 3 of 4

IA Certified Tree Worker Climber pecialist kills Test Evaluation Form ECOND DEIGNATED WORK TATION Climber demonstrates controlled use of climbing rope. E OF POLE AW/PRNER Climber must request pole be set up from ground. Climber demonstrates the use of a pole saw or pruner to reach flagged limb. G. POLE AW/PRNER WORK TATION Climber should never be in a position to fall (unchecked) greater than 3 feet (0.91 meters). An uncontrolled swing or slip may lead to an unsatisfactory mark and may not constitute failure. Climber should maintain balance and confident posture. Climber should be secured. 15 Climber should use both hands on pole saw/pruner. Pole saw/pruner safely replaced in tree. Pole saw/pruner safely lowered to ground. Pole saw/pruner cannot be dropped. Points Deducted ection G: 20 DECEND TO GROND Climber demonstrates sufficient length of rope to reach the ground. TOTAL TIME LIMIT H. DECENT Pull up running end of climbing rope or show figure-8 stopper knot. Climber should descend and land in a controlled manner at a safe speed without damaging rope. Must be complete in 30 minutes. Points Deducted ection H: 30 Revised 11/11 Pg. 4 of 4

V. INTRCTION FOR COMPLETING & BMITTING APPLICATION 1. Print your first name, your middle initial, and your last name. Note: For security reasons please list your name as it appears on your photo ID you will be bringing to the exam site. 2. Print your address. The address you indicate will be used for all future correspondence by IA. note if you move, to contact IA with your updated address information. 3. Print your phone number, cell/alternate number, fax number, and e-mail address. 4. Write the date of the desired scheduled knowledge exam. Do not submit application without choosing an exam date. This will be left blank if you are testing via computer based. 5. Write the location of the scheduled knowledge exam. (Chapter sponsored exams only) 6. the box for computer based testing if you wish to test at Pearson Vue testing centers. 7. Write the date of the scheduled skills exam. 8. Write the location of the scheduled skills exam. 9. the box for the language in which you wish to take the test, English or panish.. check if you are including a CTW waiver form. 11. the box if you do NOT want your listing to appear in Certified Arborists lists. 12A. yes if you are a member of IA. It is important to write in your IA member ID number. 12B. yes if you are a member of an IA chapter. Be sure to write in the appropriate chapter. Note: You may check yes if you enclose an IA membership application and all of the necessary fees for membership to IA and the chapter. 13. If you are requesting special accommodations, be sure to contact the Certification Department prior to submitting your application and before the exam deadline date. 14. Complete all of the practical experience section, including employment dates. If this section is not completed correctly, your application will not be accepted. 15. complete the form and attach all necessary proof of training in CPR, first aid, and aerial rescue. 16. Include the appropriate fees with your application. If you are applying for IA and chapter membership, you may pay the member rate, but a membership application must accompany the certification application. You may pay both fees with one check or credit card. The IA certification fee is separate and distinct from IA and IA chapter dues. Note: MasterCard/VIA/AmEx may be used to pay for membership and/or certification fees. REQIRED: sign and date the Certification Agreement. If you have further questions while you are filling out the application, please contact the IA Certification Department at 217.5.9411. If you desire further information on IA or IA certification, you may access the IA website at www.isa-arbor.com PLEAE ATTACH ALL DOCMENTATION REQIRED FOR BMITTAL! Thank You