Information

  • Prepared by

  • Conducted on

Vehicle Information

Vehicle Information

  • Truck Number

  • mileage

  • Exterior Front photo

  • Exterior drivers side photo

  • Exterior rear photo

  • Exterior Passenger side photo

  • Interior Passenger side photo (Both Doors Opened)

  • Interior Drivers Side Photo (Both Doors Opened)

Cab Interior

  • Window Operation

  • Door Locks in working order

  • Seatbelts in working order

  • Interior Lights Work

  • Hazard lights work

  • Back-up Camera operational and adjusted properly

  • All company forms present

  • sales agreements

  • Pre Application Notices

  • Post Application Notices

  • Ban Welcome Packets

  • Seasonal Marketing Materials

  • Printer in good condition and stored properly

  • Heater and A/C working

  • Overall cleanliness of cab

  • overall storage practices in Cab

Accident Packet/Emergency Products

  • Insurance Card

  • Incident Reports

  • Accident Investigation Form

  • Instruction Sheet

  • UA Sign Off Form

  • Concentra Location Form

  • First Aid Kit Present and Stocked Properly

  • Spill Kit

PPE

  • Safety cone present and in good conditon

  • Bump Cap/Hard Hat present and in working condition.

  • Safety Glasses and Goggles present

  • Respirator present and stored properly

  • Extra Uniform

  • Coveralls Present

  • Spare Pair of work Boots. (Illinois only)

  • Stinging Insect PPE Present and in good condition

Exterior

  • Windows and windshield in good condition

  • Windshield wiper working

  • Turn signals working

  • Headlights functional low and high beam

  • Tail Lights & Brake Lights

  • Tires in good condition

  • Low Tread Life left

  • Damaged tires

  • Horn working

  • Mirrors properly adjusted/convex mirrors installed

  • Extension Ladder Properly Secured on vehicle

  • Overall Cleanliness of exterior

  • Additional comments/observations or exterior damages noted attach photos below

  • Observation
  • Add media

  • Add observations/comments here.

Truck Bed

  • products properly stored

  • water containers labeled

  • product containers labeled and sealed.

  • Proper amounts of products present.

  • Too much Product

  • To little product

  • Truck Cap Locks in working order

  • Overall cleanliness of truck bed

  • Storage Practices in truck bed

Signatures

  • I hereby certify that all information is accurate and that an actual inspection was conducted.

  • Auditor's Printed Name & Signature

  • Technicians signature

Ladder Inspections

STEP LADDER (Little Giant or telescoping)

  • 1) Ladder joints are tight

  • 2) Rungs and side rails are free of slip hazards

  • 3) Rungs Undamaged

  • 4) Safety feet present and in good working order

  • 5) Side rails undamaged

  • 6) Warning Labels Present and legible.

Small folding step ladders (If applicable)

  • 1) Ladder Joints are tight?

  • 2) Rungs and side rails are free of slip hazards?

  • 3) Safety feet are present and in good working order?

  • 4) Rungs are undamaged?

  • 5) Side rails are undamaged?

  • 6) Warning Labels Present and legible.

Extension ladders

  • 1) Ladder joints are tight?

  • 2) Ladder extension stops are present and functional?

  • 3) Pulleys are in good working order?

  • 4) Pulley ropes are in good condition?

  • 5) Rungs and side rails are free of slip hazards?

  • 6) Rungs undamaged?

  • 7) Safety feet present and in good working order?

  • 8) Side rails undamaged?

  • 9) Warning Labels Present and legible.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.