Information
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Document No.:
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Conducted on:
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Driver/Auditor:
Mine Radio
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Access to working mine radio
Documentation
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Odometer
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Training paperwork, job paperwork, access badges
Interior
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Air Conditioner
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Window Operation
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Windshield
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Door Locks
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Seatbelts
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Interior Lights
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Mirrors properly adjusted
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No Warning Lights turned on
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Shovel, 1 gallon of water, gloves, shovel, and hot/cold weather clothing
Engine Compartment
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Windshield washer
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Engine oil level
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Coolant level
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Battery working
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Brake Fluid level
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Transmission Fluid Level
Exterior
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Windows and windshield wipers working and in good condition
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Tail Lights, Brake lights, headlights and turn signals functioning
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Emergency brake in good condition
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Power brakes in good condition
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Wheels and Tires in good condition
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Bald tires
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Not inflated properly
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Damaged tires
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Horn working
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No grease leak
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No fuel leaks
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Exhaust system in good condition
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Fire extinguisher in good condition and charged
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Additional comments/observations i.e. Damage to vehicle
Observation
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Add observations/comments here.
Signatures
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I hereby certify that all information is accurate and that an actual inspection was conducted.
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Auditor's Printed Name & Signature
