Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
VAN DETAILS.
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Date And time of Audit
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Van Registration
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Take Picture of Van being Audited
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Odometer reading
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RUC'S Valid for 500kms
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Van Registration Valid for 2 weeks.
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Van Warrant Valid for 2 weeks.
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Van Service not due for 2 weeks
VAN EXTERIOR CHECK
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The high and low beams are operational
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The left and right tail lights are operational
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The left and right turn signals are operational
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The left and right break lights are operational
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The left and right reverse lights are operational
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The windscreen is free of damage
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Front hood, bumper and grill are free of damage
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Driver side door, window and fender free of damage
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Drivers side free of damage
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Rear window free of cracks and chips, rear of van free of damage
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Rear door operational
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Passenger side free of damage
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Van side access door operational
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Passenger door , mirror and fender free of damage
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All tyres at correct pressure, free of damage and correct tread
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Van exterior clean
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NZDDA Signage Attached and in good condition
VAN ENGINE BLOCK
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Engine block clean and free of damage
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Van has sufficient clean oil
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Van has sufficient power steering fluid
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Van has sufficient break fluid
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Van has sufficient coolant
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Van has sufficient window washing fluid
VAN INTERIOR
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All seat belts fitted are operational
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All seats are in good working condition
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Windscreen wipers are operational and in good condition
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Heater and defroster are operational
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Air-conditioning is operational
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Dashboard lights are operational
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All gages are operation and showing correct ranges
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Horn is operational
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Cab free of loose dangerous objects
TESTING FACLITY
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Toilet clean and in good working condition
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Cassette clean, in good working condition and contain blueing agent
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Flusher in good working oder and contains coloring agent
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Hand basin free of in good working order
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Hand basin has sufficient water, gray water tank empty
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Van has sufficient soap
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Van table and seats in good working oder and free of damage
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Van Interior clean
NZDDA TESTING EQUIPMENT
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Van has sufficient Urine Devices
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Van has sufficient Syncan Devices
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Van Alcolizer is operational and not due for recalibration
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Van has sufficient Alcolizer mouth pieces
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Van has sufficient ESR collection kits and Chain of Custody forms
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Van has sufficient CantLabs collection kits and Chain of Custody forms
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Van has sufficient NZDDA 1.1 and 1.2 forms
SIGNATURES
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Signature of Auditor
SUMMARY
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Final comments / conclusions / recommendations