Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

VAN DETAILS.

  • Date And time of Audit

  • Van Registration

  • Take Picture of Van being Audited

  • Odometer reading

  • RUC'S Valid for 500kms

  • Van Registration Valid for 2 weeks.

  • Van Warrant Valid for 2 weeks.

  • Van Service not due for 2 weeks

VAN EXTERIOR CHECK

  • The high and low beams are operational

  • The left and right tail lights are operational

  • The left and right turn signals are operational

  • The left and right break lights are operational

  • The left and right reverse lights are operational

  • The windscreen is free of damage

  • Front hood, bumper and grill are free of damage

  • Driver side door, window and fender free of damage

  • Drivers side free of damage

  • Rear window free of cracks and chips, rear of van free of damage

  • Rear door operational

  • Passenger side free of damage

  • Van side access door operational

  • Passenger door , mirror and fender free of damage

  • All tyres at correct pressure, free of damage and correct tread

  • Van exterior clean

  • NZDDA Signage Attached and in good condition

VAN ENGINE BLOCK

  • Engine block clean and free of damage

  • Van has sufficient clean oil

  • Van has sufficient power steering fluid

  • Van has sufficient break fluid

  • Van has sufficient coolant

  • Van has sufficient window washing fluid

VAN INTERIOR

  • All seat belts fitted are operational

  • All seats are in good working condition

  • Windscreen wipers are operational and in good condition

  • Heater and defroster are operational

  • Air-conditioning is operational

  • Dashboard lights are operational

  • All gages are operation and showing correct ranges

  • Horn is operational

  • Cab free of loose dangerous objects

TESTING FACLITY

  • Toilet clean and in good working condition

  • Cassette clean, in good working condition and contain blueing agent

  • Flusher in good working oder and contains coloring agent

  • Hand basin free of in good working order

  • Hand basin has sufficient water, gray water tank empty

  • Van has sufficient soap

  • Van table and seats in good working oder and free of damage

  • Van Interior clean

NZDDA TESTING EQUIPMENT

  • Van has sufficient Urine Devices

  • Van has sufficient Syncan Devices

  • Van Alcolizer is operational and not due for recalibration

  • Van has sufficient Alcolizer mouth pieces

  • Van has sufficient ESR collection kits and Chain of Custody forms

  • Van has sufficient CantLabs collection kits and Chain of Custody forms

  • Van has sufficient NZDDA 1.1 and 1.2 forms

SIGNATURES

  • Signature of Auditor

SUMMARY

  • Final comments / conclusions / recommendations

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