Title Page
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Conducted on
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Prepared by
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Registration Number
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Odometer/Hub Start
Pre-Start Checklist
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Outstanding Faults
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Safety Check
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Oil and Coolant
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Inside Cab
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Lights, Beacons and Reflectors
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Wheels and Tyres
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Body and Equipment
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Safety Equipment
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Equipment/Site Specific Items
Workers Pre-Start Declaration: I certify that
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I am fit for work
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I have the appropriate, valid Driver Licence and appropriate PPE for operation of this vehicle
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I have conducted the above Pre-Start Checklist and I am satisfied that the vehicle is safe and ready to operate
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Signature
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Date and Time