Aid 76 Weekly

• Document No.

• Audit Title

• Conducted on

  Date

Aid 76 Weekly

• Fuel Level

  Full

  3/4

  1/2

  1/4

  Empty

• Battery Level

• Parking Brake

  Yes

  No

  N/A

• Radio Channel (Bravo 1)

  Yes

  No

  N/A

• Portable Radios

  1

  2

• Find or Note Missing Portable Radio

• Cell Phone

  Yes

  No

  N/A

• Find or Note Missing Cell Phone

• Horn/Siren/PA Setting

  Yes

  No

  N/A

• Non-Emergency Lights

  Yes

  No

  N/A

• Emergency Lights

  Yes

  No

  N/A

• Windows

  Yes

  No

  N/A

• Exterior Damage

  Yes

  No

• Interior Damage

  Yes

  No

• KED/Disposable Splints

  Yes

  No

  N/A

• C-Spine/Backboards/Straps

  Yes

  No

  N/A

• Traction Splint

  Yes

  No

  N/A

• BLS Box/Airway Box

  Yes

  No

  N/A

• Main Oxygen Tank (Above 1000)

  Yes

  No

  N/A

• Stretcher O2 Bottle (Above 1000)

  Yes

  No

  N/A

• Spare O2

  Yes

  No

  N/A

• LifePak User Test

  In Service

  Out of Service

• Engine Oil Level

  Safe

  At Risk

  N/A

• Power Steering Fluid

  Safe

  At Risk

  N/A

• Transmission Fluid

  Safe

  At Risk

  N/A

• Coolant Fluid

  Safe

  At Risk

  N/A

• Engine Belt/Fluid Leaks

  Safe

  At Risk

  N/A

• Tire Pressure Thump

  Safe

  At Risk

  N/A

• EMS Supply/Rig Restock

  Yes

  No

  N/A

• Gurney Operation

  In Service

  Out of Service

• Decon Floor/Doors

  Yes

  No

  N/A

• SCBA Inspection

  In Service

  Out of Service

• Mileage

• Rig Check-off Signature

  Sign