Information

  • Name of Report:

  • Document No.

  • Fueled on:

  • Prepared by:

  • Location (Drop pin for GPS of fuel tank):
  • Will you be fueling this piece of equipment today?

  • Equipment Fuel (Items in Red are mandatory sections)
  • Equipment ID #: (You must input the equipment ID to complete the report)

  • Please take photo of gauge when fueling is completed:

  • Fuel tank reading (starting gallons):

  • Gallons of Fuel Dispensed

Signature:

  • Fuel Attendant:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.