EMCOR Betlem Annual Vehicle Inspection Checklist

• Truck Number

• Truck Assigned To:

• Truck Mileage:

• This Document Had Been Prepared By

• Conducted on

  Date

• Signature

  Sign

Lockout/Tag Out

• Is standard issue entry isolation equipment available in appropriate condition?

• (3) Keyed locks and identification tags

  Yes - All 3 are present

  No- Need to order

  N/A

• Comments

• (3) Group Lockouts or Hasps

  Yes - All 3 are present

  No- Need to order

  N/A

• Comments

Personal Protective Equipment:

• Please select all that apply:

  Select Safety glasses/Impact Goggles Present Safety glasses/Impact Goggles Missing Face Shield/Chemical Goggles Present Face Shield/Chemical Goggles Missing Head Protection/ Hard Hat Present Head Protection/ Hard Hat Missing Hearing Protection Present Hearing Protection Missing Appropriate Gloves/Protective Equipment Present Appropriate Gloves/Protective Equipment Missing Steel-toed Boots (unless tech already wearing some) Present Steel-toed Boots (unless tech already wearing some) Missing Bump Cap Present Bump Cap Missing

  • Safety glasses/Impact Goggles Present
  • Safety glasses/Impact Goggles Missing
  • Face Shield/Chemical Goggles Present
  • Face Shield/Chemical Goggles Missing
  • Head Protection/ Hard Hat Present
  • Head Protection/ Hard Hat Missing
  • Hearing Protection Present
  • Hearing Protection Missing
  • Appropriate Gloves/Protective Equipment Present
  • Appropriate Gloves/Protective Equipment Missing
  • Steel-toed Boots (unless tech already wearing some) Present
  • Steel-toed Boots (unless tech already wearing some) Missing
  • Bump Cap Present
  • Bump Cap Missing

• Please write down what PPE needs to be replaced/ordered

Ladders

• Appropriate non-conductive ladder(s) available for use?

  Yes

  No

  N/A

  Needs to be ordered

• Comments

• Is/Are the available ladder(s) inspected and in good condition?

  Select Yes No N/A Needs to be ordered

  • Yes
  • No
  • N/A
  • Needs to be ordered

• Comments

Electrical, Electrical Cords, GFCI, Tools

• Electrical cords are free of damage and defect, including cord insulation, excessive wear, damage or remove ground plug or strain relief?

  Yes- All Damage Free

  No- Some Damage Present

  N/A

• Please note which cords need to be replaced/ re-ordered?

• Does the unit have at least two GFCI pig tails?

  Yes

  No

  N/A

  Needs to be ordered

• Please note what needs to be ordered

• Have all electrical tools been properly maintained and inspected prior to use?

  Yes

  No

  N/A

• Please note what needs to be ordered

• Is a voltage tester multi-meter present?

  Yes

  No

  N/A

• Is personal protective electrical NFPA 70E Kit (including gloves, leather protectors and appropriate k-calorie protective clothing) available?

  Yes

  No

  N/A

• Does a voltage tester multi-meter need to be ordered?

  Yes

  No

  N/A

• Please specify if any single item or multiple items need to be ordered for the NFPA 70E Kit:

Incident Reporting

• Is a Fleet Accident Reporting Kit with Camera readily available?

  Yes

  No

  N/A

• Do any items need to be ordered?

• Please confirm that you have an understanding of the injury reporting procedure and that the information is available on the vehicle.

  Yes

  No

  N/A

• Comments

Misc. Items/Inventory

• Appropriate/properly inspected fire extinguisher on unit/truck?

  Yes

  No

  N/A

• Expiration Date?

  Date

• Additional Comments

• Appropriately maintained First Aid Kit

  Yes

  No

  N/A

  Needs to be ordered

• Comments

• Driver's Alert stickers appropriately displayed?

  Yes

  No

  N/A

• Comments

• EMCOR Facility Services stickers appropriately displayed?

  Yes

  No

  N/A

• Comments

Misc. Licenses/Paperwork

• Insurance, registration, driver's license available and current?

  Yes

  No

  N/A

• Expiration Date

  Date

• Comments

• Technician has completed OSHA 10 or OSHA 30 hour program? (Please select all that apply.)

  Completed OSHA 10 Hour Program

  Completed OSHA 30 Hour Program

  OSHA Training INCOMPLETE

  N/A

• Comments

• A copy of applicable EFS Safe Work Procedures maintained on the unit?

  Yes

  No

  N/A

• Comments

• Service technician is aware of EMCOR fleet policy including cell phone and seatbelt usage?

  Yes

  No

  N/A

• Comments

Misc. Vehicle Status Update

• Condition of vehicle per fleet policy? (Report any scratches, dings, cracks, etc., in the comments section.)

  Yes

  No

  N/A

• Comments

• Tool inventory confirmed per original distribution of mobile service start-up?

  Yes

  No

  N/A

• Comments

• Cargo area clean and orderly?

  Yes

  No

  N/A

• Comments

• Tanks and cylinders secured?

  Yes

  No

  N/A

• Comments

Misc. Service Tech Info

• Appropriate professional appearance in company provided uniforms?

  Yes

  No

  N/A

• Comments