Title Page
Audit Information
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Date
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Auditors Name
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Engineers Name
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Department
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Who is your Manager
Access Equipment
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Any access equipment on the vehicle
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Description - eg 5 tread steps or 3x12 tread extenion ladders
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labelled
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Detail number
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Safe for use - not damaged in any way - extension ladders must be in sets of 3
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Remind safety of working at height and using correct equipment
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Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Any access equipment on the vehicle 2
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Description - eg 5 tread steps or 3x12 tread extenion ladders
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labelled
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Detail number
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Safe for use - not damaged in any way - extension ladders must be in sets of 3
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Remind safety of working at height and using correct equipment
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Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Any additional access equipment on vehicle?
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Any access equipment on the vehicle
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Description - eg 5 tread steps or 3x12 tread extenion ladders
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labelled
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Detail number
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Safe for use - not damaged in any way - extension ladders must be in sets of 3
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Remind safety of working at height and using correct equipment
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Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Any additional access equipment on vehicle?
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Any access equipment on the vehicle 4
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Description - eg 5 tread steps or 3x12 tread extenion ladders
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labelled
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Detail number
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Safe for use - not damaged in any way - extension ladders must be in sets of 3
-
Remind safety of working at height and using correct equipment
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Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Any additional access equipment on vehicle?
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Any access equipment on the vehicle
-
Description - eg 5 tread steps or 3x12 tread extenion ladders
-
labelled
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Detail number
-
Safe for use - not damaged in any way - extension ladders must be in sets of 3
-
Remind safety of working at height and using correct equipment
-
Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Any additional access equipment on vehicle?
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Any access equipment on the vehicle
-
Description - eg 5 tread steps or 3x12 tread extenion ladders
-
labelled
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Detail number
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Safe for use - not damaged in any way - extension ladders must be in sets of 3
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Remind safety of working at height and using correct equipment
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Engineer to sign to say they will not use the access equipment - remove from use where possible
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Photo of access equipment
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Electrical equipment
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Is there electrical items on the van - personal or company owned
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Description including voltage
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Safe for use
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Inform of importance of safe work equipment and remove from use
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Engineer to sign to say equipment will not be used
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Is item PAT tested
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PAT Test as required
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Comments on equipment - detail items PAT tested
Test Equipment
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Is there any testing equipment on the vehicle 1
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Make
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Model
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Type
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Serial number
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Serial number photo
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Calibration date
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Additional comments
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Is there any testing equipment on the vehicle 2
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Make
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Model
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Type
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Serial number
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Serial number photo
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Calibration date
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Additional comments
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Is there any testing equipment on the vehicle 3
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Make
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Model
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Type
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Serial number
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Serial number photo
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Calibration date
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Additional comments
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Is there any testing equipment on the vehicle 4
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Is there any testing equipment on the vehicle
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Make
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Model
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Type
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Serial number
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Serial number photo
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Calibration date
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Additional comments
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Is there any testing equipment on the vehicle 5
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Make
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Model
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Type
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Serial number
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Serial number photo
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Calibration date
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Additional comments
Harness
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Do you have a harness on your van.
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Harness Type 1
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Manufacturer
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Manufacture date
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Serial Number
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Free of damage
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Photo
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Are you harness trained in inspection and fitting
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All users should be trained - action for training
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Comments
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Do you have another harnes
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harness Type 2
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Manufacturer
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Manufacture date
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Serial Number
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Free of damage
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Photo
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Are you harness trained in inspection and fitting
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All users should be trained - action for training
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Comments
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undefined
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Do you have another harnes
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Harness Type 3
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Manufacturer
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Manufacture date
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Serial Number
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Free of damage
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Photo
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Are you harness trained in inspection and fitting
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All users should be trained - action for training
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Comments
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Any additional items
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Detail any other equipment 2
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Detail any other equipment 3
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Detail any other equipment 4
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Detail any other equipment 5
Vehicle Equipment
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No smoking or vaping sign in van
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Has one been installed
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Spare wheel on van and fully inflated
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detail action taken
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Wheel jack on van and complete
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Vehicle checklist carried out
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detail why no vehicle check has been completed
Auditors Signature
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All information is correct
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Signature
Engineers Signature
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All information is correct
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All equipment above owned by Barlows UK Ltd is loaned to you as the employee and you are responsible for the safety and security of them at all time. You are liable for any lost or misplaced items.
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Signature