FMA Vehicle Inspection

• Document No.

• Conducted on

  Date

• Completed by: (Print and Sign)

  Sign

VEHICLE DESCRIPTION

• Vehicle Reg No

Electrics

• Headlights working

  Yes

  No

  N/A

• Tail lights working

  Yes

  No

  N/A

• Signal Indicators

  Yes

  No

  N/A

• Exterior Beacon light

  Yes

  No

  N/A

• Battery

  Yes

  No

  N/A

• Are there any faults?

  Yes

  No

  N/A
Faults found

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media

Fluid Levels

• Oil Level

  pass

  fail

  added

• Coolant Level

  pass

  fail

  added

• Washer Fluid

  pass

  fail

  added

• Break Fluid

  pass

  fail

  added

• Transmission Fluid

  pass

  fail

  added

• Hydraulic Fluid (if any)

  pass

  fail

  added

Tyres Condition to be checked daily Pressure to be checked weekly

• Front - Right

  Safe

  At Risk

  N/A

• Is the tyre at the correct pressure

• Rear - Left

  Safe

  At Risk

  N/A

• Is the tyre at the correct pressure

• Rear - Right

  Safe

  At Risk

  N/A

• Is the tyre at the correct pressure

• Front - Left

  Safe

  At Risk

  N/A

• Is the tyre at the correct pressure

• Spare tyre

  Safe

  At Risk

  N/A

• Is the tyre at the correct pressure

• Are there any faults?

  Yes

  No

  N/A
Faults found

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media

Exterior

• Exterior clean

  Yes

  No

  N/A

• Exterior body damage

  Yes

  No

  N/A

• Wing mirrors

  Yes

  No

  N/A

• Windscreen

  Safe

  At Risk

  N/A

• Windscreen wipers

  Safe

  At Risk

  N/A

• Details of any damage

• Are there any faults?

  Yes

  No

  N/A
Faults found

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media

Interior

• Interior General Condition - clean and tidy

  Yes

  No

  N/A

• Seat condition

  pass

  damaged

• Roof liner and carpet

  pass

  damaged

• Dashboard

  pass

  damaged

• Safety belts front and rear

  pass

  damaged

• Rear view mirror

  pass

  damaged

• Are there any faults?

  Yes

  No

  N/A
Faults found

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media

General Car equipment

• Jack

  available

  missing

  damaged

• Vehicle tool kit

  available

  missing

  damaged

• First Aid kit

  Yes

  No

  N/A

• Items in first aid kit Green yes Red no

  Select triangular bandage triangular bandage padded bandage padded bandage note pad note pad large bandage large bandage accident book accident book small bandage small bandage lint lint eye patch eye patch eye wash eye wash safety pins safety pins

  • triangular bandage
  • triangular bandage
  • padded bandage
  • padded bandage
  • note pad
  • note pad
  • large bandage
  • large bandage
  • accident book
  • accident book
  • small bandage
  • small bandage
  • lint
  • lint
  • eye patch
  • eye patch
  • eye wash
  • eye wash
  • safety pins
  • safety pins

• AED

  available

  missing

  damaged

• Items in case

  Select razor razor scissors scissors in date pads in date pads mouth mask mouth mask instruction leaflet instruction leaflet

  • razor
  • razor
  • scissors
  • scissors
  • in date pads
  • in date pads
  • mouth mask
  • mouth mask
  • instruction leaflet
  • instruction leaflet

• Are there any faults or any equipment missing or damaged?

  Yes

  No

  N/A
Faults found

• Missing equipment

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media

Other

• Details of any other vehicle issues

• Picture(s) of any other issues

  Media

• Are there any faults?

  Yes

  No

  N/A
Faults found

• Equipment to be faulted

• Description of fault

• Fault number

• If required add picture here

  Media