Mansfield Car 1

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicle Description

• Odometer reading at inspection

• Is the vehicle due for a service within the next month?

  Yes

  No

  N/A

• Has a vehicle being driven within the last two weeks?

  Yes

  No

  N/A

• A test drive is required.

EXTERIOR LIGHTS

• High / Low Beams Operational

  Yes

  No

  N/A

• Driving Light Operational and Aligned

  Yes

  No

  N/A

• Clearance Marker 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 Brake Lights Operational

  Yes

  No

  N/A

• Left and Right Reversing Lights Operational

  Yes

  No

  N/A

• License Plate Light Operational

  Yes

  No

  N/A

• Reversing Beeper Operational

  Yes

  No

  N/A

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

• Windscreen Free of Cracks and Chips

  Yes

  No

  N/A

• Front Bonnet, Grill and Bumper Free of Damage

  Yes

  No

  N/A

• Right Mirror is Adjustable and Free of Damage

  Yes

  No

  N/A

• Right Doors are Free of Damage

  Yes

  No

  N/A

• Right Side Windows are Free of Chips, Cracks and Scratches

  Yes

  No

  N/A

• Right Side of Vehicle Free of Damage

  Yes

  No

  N/A

• Rear of Vehicle and Bumper is Free of Damage

  Yes

  No

  N/A

• Rear Windows Free of Chips, Scratches and Cracks

  Yes

  No

  N/A

• Left Side of Vehicle is Free of Damage

  Yes

  No

  N/A

• Left Side Windows are Free of Chips, Cracks and Scratches

  Yes

  No

  N/A

• Left Side Doors are Free of Damage

  Yes

  No

  N/A

• Left Mirror is Adjustable and Free of Damage

  Yes

  No

  N/A

• Vehicle is Clean and free of Road Grime and Dirt

  Yes

  No

  N/A

TYRES

• Front Right Tyre in Good Condition

  Yes

  No

  N/A

• Rear Right Tyre in Good Condition

  Yes

  No

  N/A

• Front Left Tyre in Good Condition

  Yes

  No

  N/A

• Rear Left Tyre in Good Condition

  Yes

  No

  N/A

• Spare Tyre is in Good Condition and Inflated Correctly

  Yes

  No

  N/A

INTERIOR

• Driver Seat in Good Condition

  Safe

  At Risk

  N/A

• Driver Seat Belt Operational

  Safe

  At Risk

  N/A

• Windscreen Wipers Working Properly and in Good Condition

  Yes

  No

  N/A

• Windscreen Washer Working Properly and Full

  Yes

  No

  N/A

• Heater and Defroster Working

  Yes

  No

  N/A

• Air Conditioner Operational

  Yes

  No

  N/A

• Dashboard Lights Operational

  Yes

  No

  N/A

• All Gauges Operating

  Yes

  No

  N/A

• Interior Lights Operational

  Yes

  No

  N/A

• Rear Cabinet Doors Operational

  Yes

  No

  N/A

• Rear Cabinet Lights Operational

  Yes

  No

  N/A

• Grab Rails Secure

  Yes

  No

  N/A

• Interior is Clean and Free of Loose Objects

  Yes

  No

  N/A

• Reversing Camera Operational

  Yes

  No

  N/A

• Passenger Seat Belts Operational

  Yes

  No

  N/A

• Passenger Seats in Good Repair

  Yes

  No

  N/A

SAFETY EQUIPMENT

• Vehicle Radios are on Correct Channels

  Yes

  No

  N/A

• Two Handheld Radios are in Vehicle and Charged

  Yes

  No

  N/A

• EVS Siren Operates Correctly

  Yes

  No

  N/A

• EVS Light Operate Correctly

  Yes

  No

  N/A

• PA System Operational

  Yes

  No

  N/A

RESCUE EQUIPMENT

• Electrical Chainsaw Checked and Battery fully charged

  Yes

  No

  N/A

• Winch Cable in Good Condition and Wound on Drum Correctly

  Yes

  No

  N/A

• Welfare Container Fully Stocked and Best Before Dates Checked (Water Esky)

  Yes

  No

  N/A

• Is there anything that you would like to make note off.

• Is there any immediate actions that need to be taken?

• This report has been complete and is true and correct to the best of my knowledge/ability.

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