Lakemont-Wiley Squad 4 Checkoff

• Conducted on

  Date

• Prepared by

• Location
  Address

Truck Operation

• Fuel Level

  Full

  3/4

  1/2

  1/4

  Empty

• Oil Level

  OK

  Oil added as necessary

• Brakes

  OK

  Needs Attention

• Radiator Coolant Level

  OK

  Coolant added as necessary

• Battery

  Good condition

  Needs attention

• Fan Belt Tension

  Good condition

  Needs attention

• Windshield Wipers

  Good condition

  Needs attention

• Headlights, Taillights and Turn Signals

  OK

  Needs attention

• Cleanliness of interior

  OK

  Needs attention

• Cleanliness of exterior

  OK

  Needs attention

Emergency Signals

• Siren

  OK

  Needs Attention

• Emergency Lights

  OK

  Needs Attention

• Horn

  OK

  Needs Attention

Medical Equipment

• AED on board with charged battery

  Yes

  No

  N/A

• O2 tank on board and full

  Yes

  No

  N/A

• Pulse Oximeter on board and operational

  Yes

  No

  N/A

• Jump bag on board and equipped

  Yes

  No

  N/A

• Yes

  No

  N/A

Safety Equipment

• Flash lights on board and charged

  Yes

  No

  N/A

• Reflective safety vests on board

  Yes

  No

  N/A

• Yes

  No

  N/A

Fire Fighting

• Water pump cranked and running

  Yes

  No

  N/A

• Water tank level

  Full

  3/4

  1/2

  1/4

  Empty

• Water pump fuel level (gasoline)

  Full

  Fuel added as necessary

• Visual inspection of hoses and nozzels

  Yes

  No

  N/A

• Visual Inspection of rakes, shovels, etc.

  Yes

  No

  N/A

• Chain saw cranks and operates properly

  Yes

  No

  N/A

• Gasoline can on board

  Full

  3/4

  1/2

  1/4

  Empty

• Backpack blowers fueled and operational

  OK

  Needs attention