MA078 - Monthly Van Check Sheet Marine - V1 - 220104

• Site conducted

  Select

• Branch

  Falmouth

  Newcastle

  Southampton

  Scotland

• Inspection Date

  Date

• Inspected By

• Vehicle Registration No:

• Make/Model:

• Mileage:

• Drivers Name:

• Date of Last Service:

  Date

Passenger Compartment

• Condition and function of seat belts

  Compliant

  Non-Compliant

  N/A

• Condition of upholstery

  Good

  Fair

  Poor

  N/A

• Has the daily defect book been completed daily

  Yes

  No

  N/A

• Vehicle handbook in glove compartment

  Yes

  No

  N/A

• General compartment clean

  Good

  Fair

  Poor

  N/A

• First aid kit present, stocked and in date (Sterilised items have expiry dates)

  Yes

  No

  N/A

• Fire extinguisher present and serviced within the previous 12 months

  Yes

  No

  N/A

• Spare number plate for towing

  Yes

  No

  N/A

• No Smoking sign visible

  Yes

  No

  N/A

Lights

• General Condition of all External Lights

  Good

  Fair

  Poor

  N/A

• Brake lights

  Compliant

  Non-Compliant

  N/A

• Dipped/ Full Beam

  Compliant

  Non-Compliant

  N/A

• Indicators/4 ways

  Compliant

  Non-Compliant

  N/A

• Fog lights

  Compliant

  Non-Compliant

  N/A

• Number plate lights

  Compliant

  Non-Compliant

  N/A

Engine Bay

• Coolant level

  Compliant

  Non-Compliant

  N/A

• Engine oil level

  Compliant

  Non-Compliant

  N/A

• Windscreen wash bottle contains screen wash

  Compliant

  Non-Compliant

  N/A

• Brake / clutch fluid

  Compliant

  Non-Compliant

  N/A

• Oil or waste leaks

  Compliant

  Non-Compliant

  N/A

• Power steering fluid

  Compliant

  Non-Compliant

  N/A

External Condition

• Condition of vehicle, bodywork

  Good

  Fair

  Poor

  N/A

• Condition of windscreen and wiper blades

  Good

  Fair

  Poor

  N/A

• Condition of roof and roof racks/bars

  Good

  Fair

  Poor

  N/A

• Condition of Lights

  Good

  Fair

  Poor

  N/A

• Condition of tyres, tyre pressure and tyre wear

  Compliant

  Non-Compliant

  N/A

• Availability of spare wheel and jack

  Yes

  No

  N/A

• Cleanliness of windscreen, windows, mirrors, lights and plates

  Good

  Fair

  Poor

  N/A

Spill Kit & PPE

• Does the vehicle have a Spill Kit

  Yes

  No

  N/A

• Spill Kit Condition

  Good

  Fair

  Poor

  N/A

• Does the vehicle have the correct PPE

  Yes

  No

  N/A

• PPE stored in kit bags

  Yes

  No

  N/A

Storage Compartment

• Compartment clean

  Good

  Fair

  Poor

  N/A

• Equipment stored correctly

  Yes

  No

  N/A

• Condition of shelving

  Good

  Fair

  Poor

  N/A

• Negative pressure units covers fitted

  Yes

  No

  N/A

Vehicle Damage

• Describe and list the location of any damage to the Company Vehicle: -

• Actions to be Taken

• By Who

• Date To Complete

  Date

• Date Completed

  Date

• Photograph Damage

  Media

Signature

• Auditors Name:

• Date of Audit:

  Date

• Inspectors Signature

  Sign