Comcast Driver Walk-Around Inspection Form 1.3

Basic Information

• Today's Date

  Date

• FFO

• Driver Name

• Supervisor

• Driver's License Number

• Driver's License Expiration Date

  Date

• Vehicle Number

• Odometer Reading

  Media

Tires

• Current Tire Condition

  Safe

  At Risk

  N/A

• Spare Tire

  Yes

  No

  N/A

Under Hood Inspection

• Brake Fluid Level

  Safe

  At Risk

  N/A

• Windshield Washer Fluid

  Safe

  At Risk

  N/A

• Hoses

  Safe

  At Risk

  N/A

• Remove Debris From Radiator Core

  Safe

  At Risk

  N/A

• Coolant Level

  Safe

  At Risk

  N/A

• Power Steering Fluid

  Safe

  At Risk

  N/A

• Transmission Fluid

  Safe

  At Risk

  N/A

• Belts

  Safe

  At Risk

  N/A

• Engine Oil

  Safe

  At Risk

  N/A

• Oil Change Mileage and Date

  Media

Lights

• Headlights

  Safe

  At Risk

  N/A

• High Beam

  Safe

  At Risk

  N/A

• Low Beam

  Safe

  At Risk

  N/A

• Hazard Lights

  Safe

  At Risk

  N/A

• Instrument Lights

  Safe

  At Risk

  N/A

• Brake Lights

  Safe

  At Risk

  N/A

• Tail Lights

  Safe

  At Risk

  N/A

• Beacon

  Safe

  At Risk

  N/A

• Turn Signals

  Safe

  At Risk

  N/A

• Check Engine Light

  Safe

  At Risk

  N/A

• Oil Pressure

  Safe

  At Risk

  N/A

• Emergency Brake Light

  Safe

  At Risk

  N/A

• Engine Temperature

  Safe

  At Risk

  N/A

Safety Features

• Air Condition/Heater/Defroster<br>

  Safe

  At Risk

  N/A

• Windshield Wipers

  Safe

  At Risk

  N/A

• Windshield/Windows

  Safe

  At Risk

  N/A

• Seat Belts

  Safe

  At Risk

  N/A

• Mirrors

  Safe

  At Risk

  N/A

• Horn

  Safe

  At Risk

  N/A

• Back Up Alarm

  Safe

  At Risk

  N/A

• Steering

  Safe

  At Risk

  N/A

• Brakes/Parking Brake

  Safe

  At Risk

  N/A

• First Aid Kit

  Safe

  At Risk

  N/A

• Cones

  Safe

  At Risk

  N/A

• Fire Extinguisher

  Safe

  At Risk

  N/A

• Foreign Voltage Detector

  Safe

  At Risk

  N/A

• AR Sticker

  Media

Ladder Rack

• Ladder Rack Secure To Roof

  Yes

  No

  N/A

• Working Properly

  Yes

  No

  N/A

Aerial Lift Vehicle

• ONAN Oil Level

  Safe

  At Risk

  N/A

• Hydraulic Fluid Level

  Safe

  At Risk

  N/A

• Hydraulic Leaks Exterior/Interior

  Safe

  At Risk

  N/A

• Upper Boom Control Operational

  Yes

  No

  N/A

• Lower Boom Control Operational

  Yes

  No

  N/A

• Generator Platform Secured

  Yes

  No

  N/A

• Boom Inspection Date

  Date

Documentation

• Vehicle Registration and Inspection Sticker (Attach Photo)

  Media

• Accident Reporting Form

  Yes

  No

  N/A

• Insurance Card

  Yes

  No

  N/A

• Vehicle Registration Form

  Yes

  No

  N/A

Personal Protective Equipment

• Hard Hat

  Safe

  At Risk

  N/A

• Safety Glasses

  Safe

  At Risk

  N/A

• Hand Protection

  Safe

  At Risk

  N/A

• Foot Protection

  Safe

  At Risk

  N/A

• Climbing Belt

  Safe

  At Risk

  N/A

Comments

• Driver Comments

• Driver Signature

  Sign

• Supervisor Signature

  Sign