Information
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Branch / Location
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Auditor
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Employees Name
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Vehicle registration number
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Type of vehicle
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Current Mileage
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Location
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Date
Revision Information
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This form is the equivalent to HSF6.2 issue 4 . This form is electronic issue 1 - 18/10/2016
Audit Type
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Please choose the employee type being audited:
General Vehicle Condition
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Is the period or mileage since last service satisfactory?
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The recommended period between services for a Vauxhall car is 24 months or 20,000 miles.
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Are the tyres within legal limits?
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Are all the vehicle lights functioning correctly including indicators?
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Is the vehicle loaded correctly?
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Is the vehicle interior clean and is a no smoking sign fitted?
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Is the exterior of the vehicle clean and free of damage?
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Is the vehicle windscreen in an acceptable condition (check for bad cracks)?
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Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?
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Is the seat and head restraint position in line with company guidelines?
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Are the parking sensors operating correctly?
Personal protective equipment / uniform
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Are the employees safety shoes or boots in a satisfactory condition?
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Is the employees Safety helmet (head protection) in a satisfactory condition?
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Safety helmet issue date.
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Please arrange for an appropriate replacement to be issued as soon as practicable
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Safety helmets to be renewed every four years irrespective of condition.
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Are the employees gloves (hand protection)in a satisfactory condition?
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Are the employees goggles / glasses (eye protection)in a satisfactory condition?
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Are the employees ear defenders (hearing protection)in a satisfactory condition?
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Is the employees hi-visibility waistcoat in a satisfactory condition?
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Is the employees dust mask (respiratory protection) in a satisfactory condition?
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Is the employees first aid kit in a satisfactory condition?
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Please arrange for an appropriate replacement to be issued as soon as practicable
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First aid kit expiry date
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Does the employee have PPE bag or suitable PPE containment?
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Is the employees asbestos emergency kit in a satisfactory condition?
Documentation and eyesight test
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Does the employee have a valid identity card?
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Please ensure an ID card is obtained as the earliest opportunity
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Expiry date
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Does the employee hold a valid driving licence
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Does the employee have an up to date employee EHS handbook?
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Can the employee correctly read a vehicle number plate 20 metres away?
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If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.
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Does the employee have a Car Safety Kit?
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Is the user / driver aware of the instructions for use of the car fire extinguisher?
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Please go through the instructions with the driver
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Car fire extinguisher expiry date
Health and Safety Passports
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Does the employee hold an ECS or CSCS card?
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Expiry date
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Please list any other safety passport including expiry dates that the employee holds:
General Vehicle Condition
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Is the period or mileage since last service satisfactory?
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The recommended period between services for a Vauxhall car is 24 months or 20,000 miles.
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Are the tyres within legal limits?
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Are all the vehicle lights functioning correctly including indicators?
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Is the vehicle loaded correctly?
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Is the vehicle interior clean and is a no smoking sign fitted?
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Is the exterior of the vehicle clean and free of damage?
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Is the vehicle windscreen in an acceptable condition (check for bad cracks)?
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Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?
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Is the seat and head restraint position in line with company guidelines?
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Are the parking sensors operating correctly?
Personal protective equipment / uniform
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Are the employees safety shoes or boots in a satisfactory condition?
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Is the employees Safety helmet (head protection) in a satisfactory condition?
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Safety helmet issue date.
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Please arrange for an appropriate replacement to be issued as soon as practicable
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Safety helmets to be renewed every four years irrespective of condition.
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Are the employees gloves (hand protection)in a satisfactory condition?
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Are the employees goggles / glasses (eye protection)in a satisfactory condition?
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Are the employees ear defenders (hearing protection)in a satisfactory condition?
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Is the employees hi-visibility waistcoat in a satisfactory condition?
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Is the employees dust mask (respiratory protection) in a satisfactory condition?
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Is the employees first aid kit in a satisfactory condition?
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Please arrange for an appropriate replacement to be issued as soon as practicable
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First aid kit expiry date
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Does the employee have PPE bag or suitable PPE containment?
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Is the employees asbestos emergency kit in a satisfactory condition?
Documentation and eyesight test
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Does the employee have a valid identity card?
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Please ensure an ID card is obtained as the earliest opportunity
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Expiry date
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Does the employee hold a valid driving licence
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Does the employee have an up to date employee EHS handbook?
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Can the employee correctly read a vehicle number plate 20 metres away?
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If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.
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Does the employee have a Car Safety Kit?
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Is the user / driver aware of the instructions for use of the car fire extinguisher?
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Please go through the instructions with the driver
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Car fire extinguisher expiry date
Health and Safety Passports
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Does the employee hold an ECS or CSCS card?
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Expiry date
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Please list any other safety passport including expiry dates that the employee holds:
General Vehicle Condition
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Is the period or mileage since last service satisfactory?
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The recommended period between services for a Vauxhall car is 24 months or 20,000 miles, a van is 25,000 or 24 months
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Are the tyres within legal limits?
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Are all the vehicle lights functioning correctly including indicators?
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Is the vehicle loaded correctly?
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Is the vehicle interior clean and is a no smoking sign fitted?
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Is the exterior of the vehicle clean and free of damage?
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Is the safety screen fitted? <br>Note: All company estate vehicles that carry company stock must have a safety screen fitted.
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Is the vehicle windscreen in an acceptable condition (check for bad cracks)?
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Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?
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Is the seat and head restraint position in line with company guidelines?
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Are the parking sensors operating correctly?
Personal protective equipment / uniform
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Are the employees safety shoes or boots in a satisfactory condition?
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Is the employees Safety helmet (head protection) in a satisfactory condition?
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Safety helmet issue date.
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Please arrange for an appropriate replacement to be issued as soon as practicable
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Safety helmets to be renewed every four years irrespective of condition.
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Are the employees gloves (hand protection)in a satisfactory condition?
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Are the employees goggles / glasses (eye protection)in a satisfactory condition?
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Are the employees ear defenders (hearing protection)in a satisfactory condition?
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Is the employees hi-visibility waistcoat in a satisfactory condition?
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Is the employees dust mask (respiratory protection) in a satisfactory condition?
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Is the employees first aid kit in a satisfactory condition?
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Please arrange for an appropriate replacement to be issued as soon as practicable
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First aid kit expiry date
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Does the employee have PPE bag or suitable PPE containment?
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Is the employees asbestos emergency kit in a satisfactory condition?
Documentation and eyesight test
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Does the employee have a valid identity card?
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Please ensure an ID card is obtained as the earliest opportunity
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Expiry date
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Does the employee hold a valid driving licence
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Does the employee have an up to date employee EHS handbook?
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Can the employee correctly read a vehicle number plate 20 metres away?
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If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.
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Does the employee have a Car Safety Kit?
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Is the user / driver aware of the instructions for use of the car fire extinguisher?
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Please go through the instructions with the driver
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Car fire extinguisher expiry date
Health and Safety Passports
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Does the employee hold an ECS or CSCS card?
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Expiry date
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Does the employee hold a 1b IPAF Licence?
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IPAF 1b Expiry Date
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Does the employee hold a 3a IPAF Licence?
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IPAF 3a Expiry Date
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Does the employee hold a 3b IPAF Licence?
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IPAF 3b Expiry Date
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Does the employee hold a SPA passport?
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SPA Expiry
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Does the employee hold a PASMA card?
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PASMA Expiry
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Please list any other safety passport including expiry dates that the employee holds:
General Vehicle Condition
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Is the period or mileage since last service satisfactory?
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The recommended period between services for a Vauxhall car is 24 months or 20,000 miles, a van is 25,000 or 24 months
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Are the tyres within legal limits?
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Are all the vehicle lights functioning correctly including indicators?
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Is the roof rack in a serviceable condition and securely fixed to the vehicle?
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Is the ladder rack and roller securely fixed to the roof rack?
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Are the ladder clamps in a serviceable condition?
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Is the vehicle loaded correctly?
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Is the vehicle interior clean and is a no smoking sign fitted?
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Is the exterior of the vehicle clean and free of damage?
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Is the safety screen fitted? <br>Note: All company estate vehicles that carry company stock must have a safety screen fitted.
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Is the vehicle windscreen in an acceptable condition (check for bad cracks)?
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Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?
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Is the seat and head restraint position in line with company guidelines?
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Are the parking sensors operating correctly?
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Is the vehicle livery in a reasonable condition and phone numbers visible?
Personal protective equipment / uniform
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Does the engineer have a full uniform?
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Are the employees safety shoes or boots in a satisfactory condition?
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Is the employees Safety helmet (head protection) in a satisfactory condition?
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Safety helmet issue date.
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Please arrange for an appropriate replacement to be issued as soon as practicable
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Safety helmets to be renewed every four years irrespective of condition.
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Are the employees gloves (hand protection )in a satisfactory condition?
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Are the employees goggles / glasses (eye protection) in a satisfactory condition?
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Are the employees ear defenders (hearing protection) in a satisfactory condition?
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Is the employees hi-visibility waistcoat in a satisfactory condition?
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Is the employees dust mask (respiratory protection) in a satisfactory condition?
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Is the employees first aid kit in a satisfactory condition?
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Please arrange for an appropriate replacement to be issued as soon as practicable
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First aid kit expiry date
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Does the employee have PPE bag or suitable PPE containment?
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Is the employees asbestos emergency kit in a satisfactory condition?
Company Equipment
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Does the engineer have ladders with a stabilising device fitted?
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Are the ladders in a satisfactory condition?
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Please ensure the ladders are removed from service and replacements are ordered ASAP
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Ladder inspection Date
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Have the ladder feet been replaced in the last 12 months?
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Please arrange to have the feet replaced ASAP
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Ladder Feet Replacement date
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Does the engineer have steps?
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Are the steps in a satisfactory condition?
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Please ensure the steps are removed from service and replacements are ordered ASAP
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Steps Inspection date
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Does the engineer have a safety belt (Working Harness)?
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Is the Safety belt in a satisfactory condition?
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Safety belt Inspection Date
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Is the engineers harness is a satisfactory condition?
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Please ensure the harness is immediately removed from service and placed into quarantine. Order replacement ASAP
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Harness Inspection Date
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Does the engineer have temporary safety barriers and tape?
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Does the engineer have an "Engineer Working" sign?
Electrical Equipment
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Does the engineers have a multimeter?
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Is the engineer's multimeter in a satisfactory condition?
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Calibration due date
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Does the engineers have an insulation tester?
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Is the engineer's insulation tester in a satisfactory condition?
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Calibration due date
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Does the engineers have a sound pressure meter?
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Is the engineer's sound pressure meter in a satisfactory condition?
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Calibration due date
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Does the engineer multi function tester?
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Is the engineer's multi function tester in a satisfactory condition?
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Calibration due date
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Does the engineers have a battery tester?
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Is the engineers battery tester in a satisfactory condition?
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Calibration due date
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Is the engineers Martindale voltage tester in a satisfactory condition?
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Is the engineers Martindale proving unit in a satisfactory condition?
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Is the engineers electrical lock off kit in a satisfactory condition?
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Does the engineers have a 110v drill and transformer?
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Is the engineer's 110v drill and transformer in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a 18v drill charger?
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Is the engineers drill charger in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a 24v drill charger?
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Is the engineers drill charger in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a power saw?
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Is the engineers power saw in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a pipe threading machine?
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Is the engineer's pipe threading machine in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a heat gun?
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Is the engineer's heat gun in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a 110v extension lead?
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Is the engineer's 110v extension lead in a satisfactory condition?
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Portable appliance test due date
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Does the engineers have a vacuum cleaner?
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Is the engineer's vacuum cleaner in a satisfactory condition?
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Portable appliance test due date
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Does the engineer have a soldering iron?
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Is the engineers soldering iron in a satisfactory condition?
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Does the engineer have a gas cylinder?
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Is the engineers gas cylinder in a satisfactory condition?
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Does the engineer have a Bosch PDO 6 Cable/Pipe detector or equivalent?
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Is the engineers Bosch PDO 6 Cable/Pipe detector or equivalent in a satisfactory condition?
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Does the engineer have pipe cutters
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Are the engineers pipe cutters in a satisfactory condition?
Tool kit
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Has the engineer been issued with a company tool kit?
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Is the soldering iron present and in a satisfactory condition?
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Is the set of 6 insulated screwdrivers present and in a satisfactory condition?
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Is the 75 mm cross screwdriver present and in a satisfactory condition?
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Are the 2 X 100 mm cross type screwdrivers present and in a satisfactory condition?
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Is the 75 mm PZ type screwdriver present and in a satisfactory condition?
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Are the 2 X 100 mm PZ type screwdriver present and in a satisfactory condition?
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Is the Utility key present and in a satisfactory condition?
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Are the VDE combination pliers 180 mm present and in a satisfactory condition?
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Are the VDE diagonal side cutter 160 mm present and in a satisfactory condition?f
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Are the VDE log nose pliers 160 mm present and in a satisfactory condition?
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Are the VDE wire stripping pliers 160 mm present and in a satisfactory condition?
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Is the 150 mm adjustable wrench present and in a satisfactory condition?
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Is the MM Hex Key Set Ball End 9 pc present and in a satisfactory condition?
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Is the AF Hex Key Set Ball End 12 pc present and in a satisfactory condition?
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Is the Hex Ratchet Crimping tool present and in a satisfactory condition?
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Is the Retractable knife present and in a satisfactory condition?
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Is the powder coated junior hacksaw present and in a satisfactory condition?
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Are the 10 X junior hacksaw blades present?
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Is the Hacksaw frame 300 mm blade present and in a satisfactory condition?
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Are the Hacksaw blades (300 X 24T) present?
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Is the Coax stripping tool present and in a satisfactory condition?
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Is the 450 g claw hammer present and in a satisfactory condition?
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Is the 1 kg club hammer present and in a satisfactory condition?
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Is the Elect bolster & guard 60 mm bulk present and in a satisfactory condition?
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Is the 4 pc soft grip chisel set present and in a satisfactory condition?
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Is the Plastic hose & pipe cutter 35 mm present and in a satisfactory condition?
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Is the 225 mm thumb turn pipe wrench present and in a satisfactory condition?
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Is the 600 mm draper level present and in a satisfactory condition?
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Is the 5 m X 19 mm measuring tape present and in a satisfactory condition?
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Is the Waterproof 5 watt hand torch present and in a satisfactory condition?
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Is the Waterproof 3 watt head torch present and in a satisfactory condition?
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Is the Heavy duty tool case 20 L present and in a satisfactory condition?
Documentation and eyesight test
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Does the employee have a valid identity card?
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Please ensure an ID card is obtained as the earliest opportunity
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Expiry date
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Does the employee hold a valid driving licence
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Does the employee have an up to date employee EHS handbook?
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Does the employee have up to date job spec./method statements?
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Does the employee have up to date risk assessments?
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Does the employee have up to date COSHH assessments?
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Can the employee correctly read a vehicle number plate 20 metres away?
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If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.
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Does the engineer have a Car Safety Kit?
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Is the user / driver aware of the instructions for use of the car fire extinguisher?
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Please go through the instructions with the driver
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Car fire extinguisher expiry date
Health and Safety Passports
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Does the employee hold an ECS or CSCS card?
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Expiry date
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ECS is required for all engineers
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Does the employee hold a 1b IPAF Licence?
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IPAF 1b Expiry Date
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Does the employee hold a 3a IPAF Licence?
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IPAF 3a Expiry Date
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Does the employee hold a 3b IPAF Licence?
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IPAF 3b Expiry Date
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Does the employee hold a SPA passport?
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SPA Expiry
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Does the employee hold a PASMA card?
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PASMA Expiry
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Please list any other safety passport including expiry dates that the employee holds:
Audit Closeout
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Please record any applicable comments:
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Staff Signature
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Add signature
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Auditors Signature
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Add signature