Title Page
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Conducted on
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Driver
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Frequency
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Prepared by
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Branch
Vehicle Information
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Vehicle Registration Number
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Vehicle Model
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Odometer / Milage Reading
Vehicle Inspection
External Check
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Windscreen free from damage?
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Front Lights & indicator working and free from damage?
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Tyres both front and rear in good condition and roadworthy with acceptable pressure and tread?
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Spare tyre and tool present in good condition?
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Bodywork / paintwork and doors in good condition from front to rear?
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Rear and side mirrors in good condition?
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Rear Brake, Reverse Lights & indicator are working and free from damage?
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Is the reverse sensor and beeper system operational?
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Is the exterior of the vehicle clean?
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Free from unauthorized sticker/ label on vehicle?
Internal Check
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Is inside the vehicle in a clean and tidy condition?
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Are all seat belts in good working order?
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Are any warning lights illuminated on dash?
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Is there a First Aid Kit on board (with adequate item)?
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Is there a Fire Extinguisher on board?<br>(2kg for fumigation vehicle, 1 kg for all other vehicles)
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Are safety triangle & 2 retractable safety cones with beacon light present in the vehicle?
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Is clean water present in 20L water tank?
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Is simple spill control kit present?<br>(Disposable absorbing paper/ cloth, disposable gloves and garbage bag)
Tools & Equipment
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Service bag/ box with necessary chemicals
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Service pouch with 6 tools below
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1. Torch light
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2. Inspection mirror
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3. Screw driver
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4. Cutter tool
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5. Scraper
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6. Gel applicator gun
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Measuring cup & filling funnel
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Poison/ Monitoring Station label
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Date of service sticker
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Barcode sticker
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Rubbish bag
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Other
Service Equipment in the vehicle required periodic inspection
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Handheld sprayer (2 units)
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Fogging Machine
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ULV Misting Machine
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Garden Spray Machine
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Hand drill (portable/ wired hammer drill)
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Ladder: Type of ladder
- Multipurpose Ladder
- Double sided Ladder
- N/A
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Other:
PPE (Correct PPE in good condition and proper storage)
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Safety Helmet (optional)
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Ear muff
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Safety Goggles (for liquid/ mist)
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Safety Glasses (for dust/ particle) (Installation)
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Respirator with replaceable filter cartridge
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N95 face mask (optional)
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Safety vest
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Spare sets of uniform
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Gloves: Type of gloves
- Chemical Resistant Gloves
- Disposable gloves
- Fire retardant gloves
- Cotton gloves
- Electric gloves
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Other:
Cargo compartment condition
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Tools, Equipment and Chemical with proper and adequate separation and secured from vehicle movement
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PPE maintained at good condition and proper storage arrangement
Maintenance Check
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Do you wish to conduct Maintenance Check in this inspection? (Every 4 months)
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Are windshield wiper and washers in working order, with water filled?
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Are engine oil levels within acceptable ranges?
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Are coolant levels within acceptable ranges?
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Are brake fluid levels within acceptable ranges?
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Are transmission fluid levels within acceptable ranges?
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Is the vehicle free of grease leaks?
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Is battery working and the vehicle starts?
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Does the car horn function correctly?
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Are all doors and door locks operational?
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Is the air conditioning operational?
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Is the roof exhaust fan operational?
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Are the brakes and hand brakes operational and in good condition?
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Is there sealant air leak on shield between cargo adn passenger compartment?
Documentation Check
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Road tax and PUSPAKOM Inspection label with valid date
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Latest APL, SDS QR Code & SRA Control Measures present?
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Is Vehicle Handbook and SHE Golden Rules (hard/ soft copy) present?
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Warning Poster: Work in progress (Fumigation, Fogging)
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Fogging Machine Safety Message label near Fogging Machine compartment
Corrective Actions
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Add additional relevant photos (specifically on non conformance)
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Any further comments or recommendations arising from this inspection?
Sign off
Sign Off
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I, the undersigned, hereby certify that all information is accurate and that an actual inspection was conducted.
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Inspector Name and Signature