Monthly LV Audit

• Site conducted

  Select

• Audit Title:

• Conducted on:

  Date

• Auditor:

• Client / Site

Identification

• Make:

• Plate Number:

• Odometer

General condition

• Cleanliness- Inside

  Media

• Cleanliness- Outside

  Media

• Cleanliness- Underside<br>

  Yes

  No

  N/A

• High Visibility Flag Fitted

  Yes

  No

  N/A

• Flashing Amber Light

  Yes

  No

  N/A

• 2-Way/Mine Radio

  Yes

  No

  N/A

• First Aid Kit and Sticker on Vehicle

  Yes

  No

  N/A

• Reverse Alarm

  Yes

  No

  N/A

• High Lights

  Yes

  No

  N/A

• Air Conditioner

  Yes

  No

  N/A

• Fire Extinguisher (Tagged and in Date)

  Yes

  No

  N/A

• Foot Brake

  Yes

  No

  N/A

• Park Brake

  Yes

  No

  N/A

• Indicators - Front

  Yes

  No

  N/A

• Indicators - Rear

  Yes

  No

  N/A

• Park Lights

  Yes

  No

  N/A

• Headlights (Low/High Beam)

  Yes

  No

  N/A

• Spotlights

  Yes

  No

  N/A

• Reversing Light

  Yes

  No

  N/A

• Tyre Condition (Front/Rear/Spare)

  Yes

  No

  N/A

• Seats & Seat Belts

  Yes

  No

  N/A

• Windows/Wipers/Washers

  Yes

  No

  N/A

• Batteries/Terminals

  Yes

  No

  N/A

• Site Compliance

  Yes

  No

  N/A

• Mud Flaps (Front/Rear)

  Yes

  No

  N/A

• Body Work Condition

  Yes

  No

  N/A

• Number Plate Light

  Yes

  No

  N/A

• Steering

  Yes

  No

  N/A

• Oil Leaks

  Yes

  No

  N/A

• Mirror - Internal

  Yes

  No

  N/A

• Mirrors - External

  Yes

  No

  N/A

• Accelerator/Brake/Clutch Pedal Rubbers

  Yes

  No

  N/A

• Tyre Changing Equipment

  Yes

  No

  N/A

• Prestart Book in Vehicle

  Yes

  No

  N/A

• Prestart Completed Each Shift

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Breakdown Triangles

  Yes

  No

  N/A

• Call up Signage

  Yes

  No

  N/A

• Windscreen

  Yes

  No

  N/A

• VHF/UHF Programmed For Required Site(s)

  Yes

  No

  N/A

• Wheel Nut Indicators

  Yes

  No

  N/A

• Isolator/Jump Start Receptacles

  Yes

  No

  N/A

• I hereby certify that all information is accurate and that an actual inspection was conducted.

• Auditor's Printed Name & Signature

  Sign