Title Page

  • Conducted on

  • Prepared by

  • Location
  • Driver Name

Check List

  • KM's:

  • Next service Date / Hrs:

  • Cabin Cleanliness

  • Environmental Cleanliness

  • Clean, free of organic materials (mud, dirt, weeds or seeds) prior to arrival

  • Horn Working

  • Clean, free of organic materials (mud, dirt, weeds or seeds) prior to arrival

  • Door operational

  • Amber flashing light

  • Seat adjustments operational

  • Headlights & turn indicators

  • Seat belt fitted and in good working order

  • First Aid Kit available

  • Levers / Controls Operational

  • Engine Mountings

  • Instruments operational

  • Engine Guarding In Good Condition

  • Exhaust Guarding In Good Condition

  • Spare wheel

  • Oil levels Good

  • Warning devices and other lights (flashing, head, tail, etc) are appropriate for the environment in which plant is being used. (check environment noise criteria particularly if working out of hours)

  • Coolant Leaks

  • Coolant System Full

  • Vee Belt Condition

  • Air Cleaner System

  • Pedals in good condition

  • Battery Mounted

  • Air conditioning operational

  • Wipers / Washers operational

  • Rear View Mirrors In Good Condition

  • Windows not damaged

  • Running Gear

  • Tyres / Wheels undamaged/ Inflated

  • Brakes operational

  • Signature:

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.