Information

  • Supervisor

  • Vehicle Registration

  • Prepared by

  • Conducted On

P - Pass M - Maintenance Required NA - Not Applicable

CATEGORY A - Defaults to be rectified immediately

  • Seat Belts

  • Horn

  • Park Brake

  • Brake Lights

  • Indicators/Hazards

  • Lights

  • Steering

  • Reverse Warning System

  • Fuel/Oil/Water Levels

  • Hydraulic Fluid Levels

CATEGORY B - Defaults to be rectified as soon as possible

  • Wipers/Washers

  • Mirrors

  • Windscreen

  • Hoses and Belts

  • Fire Extinguisher

  • Tyres

CATEGORY C - Defaults to be rectified at earliest convenience

  • Areials

  • Cab Clean

  • Damage

  • Air Conditioning

  • Jack and Tools

  • Tow Hitch

IF ANY MAINTENANCE REQUIRED, SUPERVISOR TO SIGN OFF

  • Supervisor Signature

  • ACTION TAKEN ON DEFAULT(S)

  • Employee 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.