Equipment checklist Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

INSPECTION INFORMATION

• Inspectors Name: ROCIP #

• Date/Time:

  Date

• Terminal: SA: #

• Week starting on: Ending on:

VEHICLE INFORMATION

• Vehicle Fleet Number:

  Select LIS001 LIS002 LIS003 LIS004 LIS005 LIS006 LIS007 LIS008 LIS009 LIS010 LIS0011

  • LIS001
  • LIS002
  • LIS003
  • LIS004
  • LIS005
  • LIS006
  • LIS007
  • LIS008
  • LIS009
  • LIS010
  • LIS0011

• Make & model

TIRES

• Are tire properly inflated & good condition?

  Yes

  No

  N/A

Parking/Turn Signals:

• Are Hazard/Flashers operational (front & back)?

  Yes

  No

  N/A

• Does right turn signal work (front & back)?

  Yes

  No

  N/A

Break Lights:

• Are both break lights operational?

  Yes

  No

  N/A

• Are all covers intact?

  Yes

  No

  N/A

Windshield:

• Is the windshield is good condition (no cracks)?

  Yes

  No

  N/A

• Is the windshield clean (inside & outside)?

  Yes

  No

  N/A

• Are the windshield wipers operational & in good condition?

  Yes

  No

  N/A

• Does the windshield washer fluid work properly?

  Yes

  No

  N/A

External/Sideview Mirrors:

• Are the external/sideview mirrors clean?

  Yes

  No

  N/A

• Are the external/sideview adjustable?

  Yes

  No

  N/A

Rearview Mirror:

• Is the rear view mirror clean?

  Yes

  No

  N/A

• Is the rear view mirror adjustable?

  Yes

  No

  N/A

Vehicle Gauges:

• Is there a clear line of sight to the dashboard gauges?

  Yes

  No

  N/A

• Does the speedometer work correctly?

  Yes

  No

  N/A

• Does the temperature gauge work correctly?

  Yes

  No

  N/A

• Does the fuel gauge work correctly?

  Yes

  No

  N/A

• Does the battery indicator light work correctly?

  Yes

  No

  N/A

Seat Belts:

• Are all seat belts fully operational (latch, unlatch, and lock on hard break)?

  Yes

  No

  N/A

Horn:

• Does the horn work?

  Yes

  No

  N/A

Fluids:

• Engine fluids will be checked weekly unless dashboard gauges suggest a problem. Check with safety manager to see when fluids were last checked.

• Is the oil level in the acceptable range?

  Yes

  No

  N/A

• Is the break fluid in the acceptable range?

  Yes

  No

  N/A

• Is the anti-freeze/coolant topped off?

  Yes

  No

  N/A

• Is the windshield washer fluid topped off?

  Yes

  No

  N/A

Vehicle Operations:

• Does the vehicle break properly?

  Yes

  No

  N/A

• Is the turning/steering responsive and working properly?

  Yes

  No

  N/A

• Does the vehicle idle within a an acceptable range (650-1,000 RPM)?

  Yes

  No

  N/A

EMERGENCY/WEATHER EQUIPMENT

• Are safety chains in good, working condition?

  Yes

  No

  N/A

• If the First-Aid kit fully stocked?

  Yes

  No

  N/A

• Is the Fire extinguisher fully charged?

  Yes

  No

  N/A

OTHER ISSUES

• Please described any major issues in detail below: