Heavy Vehicle Safety Check - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Inspection Date/Time

  Date

• Vehicle Name

  RIG02

  SUPPLY02

• Rego

  Yes

  No

  N/A

• Vehicle Reading

  KM

  Hours

• Value

  Yes

  No

  N/A

Physical

• Vehicle serviced according to schedule

  Yes

  No

  N/A

• Engine in good working condition

  Yes

  No

  N/A

• Headlights operational

  Yes

  No

  N/A

• Visability/ Windscreen / windows / wipers /Washers /Mirrors

  Yes

  No

  N/A

• Coolant level/checks

  Yes

  No

  N/A

• Turn signals operational

  Yes

  No

  N/A

• Break lights operational

  Yes

  No

  N/A

• Vehicle body in good condition

  Yes

  No

  N/A

• Tires in good condition

  Yes

  No

  N/A

• Truck bed and cab clean and organized

  Yes

  No

  N/A

Documentation

• MSDS book intact and crew manual present

  Yes

  No

  N/A

• Operators and Maintenance Manuals

  Yes

  No

  N/A

• Registration current

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Safety glasses & goggles used and in good condition

  Yes

  No

  N/A

• Gloves used and in good condition

  Yes

  No

  N/A

• Hearing protection available and in good condition

  Yes

  No

  N/A

Other Safety Items

• Fire extinguisher charged and inspected

  Yes

  No

  N/A

• Spill kit complete

  Yes

  No

  N/A

• Cords with ground plug in tact

  Yes

  No

  N/A

• First aid kit stocked and up to date

  Yes

  No

  N/A

• Hazard cones available and in good condition

  Yes

  No

  N/A

List any other action items that need to be corrected

• Enter/list issues here.

Signatures

• Driller

  Sign

• Offsider

  Sign