Liberty Gas Van On/Off Audit

Liberty Gas Van Audit

• Engineer

• Conducted on

  Date

• Prepared by

• Location
  Address

Van Details

• Registration

• Make

• Model

• Tax Expires

  Date

• Mileage Notice

• Mileage

• Fuel Type

  Diesel

  Petrol

  Electric/Hybrid

• Fuel in Tank

Van Safety

• Tyres Roadworthy

  Yes

  No

• Vehicle Jack Present

  Yes

  No

• Wheel Brace Present

  Yes

  No

• Locking Wheel Nuts Used

  Yes

  No

• Radio Operational

  Yes

  No

• Fluid Levels Ok, Oil/Screen Wash/Brake Fluid etc.

  Yes

  No

• Fire Extinguisher

  Yes

  No

• Type

  Water

  Foam

  CO2

  Powder

  Other

Bodywork & Glass

• Van Liveried in Liberty Gas Signage

  Yes

  No

  N/A

• Nearside Free of Damage

  Yes

  No

• Offside Free of Damage

  Yes

  No

• Front Free of Damage

  Yes

  No

• Rear Free of Damage

  Yes

  No

• Roof Free of Damage

  Yes

  No

• Windscreen and Window Free of Cracks and Chips

  Yes

  No

• Wing Mirrors and Casing Free of Damage

  Yes

  No

Van Interior

• Cab Interior Condition Satisfactory

  Yes

  No

• Van Rear Tidy and Safe

  Yes

  No

Vehicle Supplied With

• Roof Rack

  Yes

  No

• Beacon

  Yes

  No

• Towbar

  Yes

  No

• Keyfob

  Yes

  No

• Headrests

  Yes

  No

• Number of Headrests

  1

  2

  3

  4

  5

• Spare Tyre

  Yes

  No

Inspection Carried Out By

• Add signature

  Sign

• Select date

  Date

Engineers Comments

• I agree this is a true and fair record of the van at this time

  Yes

  No

• I agree to abide by the actions raised in this audits

  Yes

  No

• I understand that I may be liable for recharge for damage caused to the van

  Yes

  No

  N/A

• Add signature

  Sign

• Select date

  Date