Title Page

  • Conducted on

  • Prepared by

  • Location
  • Name of driver

  • Route number

  • Storeroom location

  • Vehicle Type & Registration

  • Odometer reading

Item to be assessed

  • Wearing Company Uniform and PPE

  • Vehicle doors and safe lockable

  • Any damage to vehicle

  • Pictures of damage (if any)

  • Van Interior & Exterior clean

  • Rear of van good condition / clear

  • Pictures of vehicle inside and out

  • Mirrors Adjusted correctly

  • Seatbelt Operational

  • Windscreen washer fluid level

  • Vehicles lights and horn operational

  • Brakes and Handbrake operational

  • Any Dashboard warning lights visible

  • Picture of dashboard with ignition on (check mileage is clear and visible)

  • Check Windscreen for chips and cracks

  • Fuel & Engine Oil check

  • Radiator Coolant check

  • Tyre Pressure including spare check

  • Tyre depth (all 4 wheels)

  • First aid box present and complete

Operator:

  • Signature:

  • Date:

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.