LOGAN CITY COUNCIL - duplicate

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

REQUIRED INFORMATION

• Date of check

  Date

• Vehicle Inspected By:

  Select Miroslav Bjelajac Stephen Atkinson Tony Burfield

  • Miroslav Bjelajac
  • Stephen Atkinson
  • Tony Burfield

VEHICLE DESCRIPTION

• Photo of Vehicle being Checked:

  Media

• Unit Number

• Make

• Model

• Odometer Reading at Inspection

EXTERIOR LIGHTING

• High and Low Beams Operational

  Yes

  No

  N/A

• Park Lights Operational

  Yes

  No

  N/A

• Left and Right Tail Lights Operational

  Yes

  No

  N/A

• Left and Right Front Turn Signals Operational

  Yes

  No

  N/A

• Left and Right Rear Turn Signals Operational

  Yes

  No

  N/A

• Left and Right Break Lights Operational

  Yes

  No

  N/A

• License Plate Light Operational

  Yes

  No

  N/A

• Left and Right Back-Up Lights Operational

  Yes

  No

  N/A

EXTERIOR BODY AND GLASS (Take Photos of any noted damage)

• Windshield Free of Cracks and Chips

  Yes

  No

  N/A

• Front Hood, Grill and Bumper free of Damage

  Yes

  No

  N/A

• Left Mirrors adjustable and Free of Damage

  Yes

  No

  N/A

• Left Fender Free of Damage

  Yes

  No

  N/A

• Left Door Free of Damage

  Yes

  No

  N/A

• Left Side Free of Damage

  Yes

  No

  N/A

• Left Side Windows Free of Cracks and Chips

  Yes

  No

  N/A

• Rear WIndow Free of Cracks and Chips

  Yes

  No

  N/A

• Rear of Vehicle and Bumper Free of Damage (Tailgate if included)

  Yes

  No

  N/A

• Right Side Free of Damage

  Yes

  No

  N/A

• Right Side Windows Free of Cracks and Chips

  Yes

  No

  N/A

• Right Door Free of Damage

  Yes

  No

  N/A

• Right Front Fender Free of Damage

  Yes

  No

  N/A

• Right Mirror Adjustable and Free of Damage

  Yes

  No

  N/A

• Vehicle is Clean and Free of Road Grime and Dirt

  Yes

  No

  N/A

UNDER THE HOOD

• Is the Engine Oil Level OK

  Yes

  No

  N/A

• Is The Coolant Level OK

  Yes

  No

  N/A

• Is There Sufficient Water in the Windscreen Washer Reservoir

  Yes

  No

  N/A

• Is There Any Visible Leaks

  Yes

  No

  N/A

TYRES

• Front Driver Tyre in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Driver (INSIDE) Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  Safe

  At Risk

  N/A

• Rear Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Passenger (INSIDE) Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  Safe

  At Risk

  N/A

• Front Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Adequate Spare Tire is Available if Necessary in Good Repair with No Visible Signs of Wear or Cracking in Sidewall

  Yes

  No

  N/A

• Front Driver and Passenger Wheel/Tire Trim Rings in Place

  Yes

  No

  N/A

• Rear Driver and Passenger Wheel/Tire Trim Rings in Place

  Yes

  No

  N/A

• Is The Tyre Pressure OK in all Tyres

  Yes

  No

  N/A

INTERIOR

• Driver Seat in Good Repair

  Safe

  At Risk

  N/A

• Driver Seat Belt Operational with Shoulder Harness

  Safe

  At Risk

  N/A

• Windshield Wipers Functioning Appropriately

  Yes

  No

  N/A

• Windshield Washer Fluid Functioning and Appropriately Wetting Windshield to Clean

  Yes

  No

  N/A

• Dashboard Lights Operational

  Yes

  No

  N/A

• All Gauges are Operating and Show within Appropriate Ranges

  Yes

  No

  N/A

• Interior Compartment Lights Operational

  Yes

  No

  N/A

• Interior is Clean and Free of Loose Objects

  Yes

  No

  N/A

• Passenger Seat Belts Operational

  Safe

  At Risk

  N/A

• Passenger Seats in Good Repair

  Safe

  At Risk

  N/A

REQUIRED DOCUMENTATION

• Date of next annual inspection due?

  Date

• Next service due (Klm's)

• Kim's for next service due?

  Yes

  No

  N/A

• Date of Last Service (List Details of Last Service, i.e. New Tires, Oil Change, ect...)

  Date

• Are Adequate Preventative Maintenance and Service Repair Records Kept

  Yes

  No

  N/A

SIGNATURES

• Signature of Auditor

  Sign

• Auditors name and agent I.D number