Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Crew

  • Have all crew received a company induction?

  • Have all crew received training for this vehicle?

  • Are crew wearing correct PPE? Hi - Vis Safety Footwear Hard Hat Gloves

  • Has the pre-start vehicle check been completed?

  • Are all Wheel Markers intact?

  • Have all Defects been reported

Vehicle Cab

Vehicle Cab Cleanliness and Hygiene

  • Is general housekeeping acceptable for the time of day? <br>Litter cleanliness etc

Vehicle Cab Equipment

Are the following items available and in date?

  • First Aid Kit

  • Fire Extinguisher

  • Gas Detector

  • Eyewash

  • Spill kit

  • Spare Safety Glasses

  • 2nd Remote (charging

  • Spare TACO rolls x2

Vehicle Equipment

Suction Hoses and Bauer Couplings

  • Is there between 25 and 35 metres of suction hose on the vehicle?

  • Is the suction hose in acceptable condition?

Are the following Bauer Couplings Available?

  • 6 to 4 inch

  • 6 to 5 inch

  • 5 to 4 inch

  • 3 to 4 inch

  • Male to male

PPE Locker

Is the following PPE available?

  • Waterproof coat

  • Waterproof trousers

  • Hi-vis vest

  • Overalls

  • Safety Boots

  • Wellies

  • Hard hat

  • Safety glasses

  • Face shield

  • Ear defenders

Freshwater Locker

Are the following items available?

  • Stand pipe (in bag)

  • Turn keys (in bag)

  • Hydrant fill hose (in bag)

  • Chlorine tablets

  • Manhole bar

  • Sledgehammer

  • Long bar (crowbar)

  • Pry bar

  • Manhole lifting key

  • Disinfectant

  • Hand lance

  • Pencil or fan jet

  • Chisel

  • Barrier tape

Other Equipment (rear locker)

Is the following equipment available?

  • Jetting heads front 1 inch

  • Jetting heads front 1/2 inch

  • Jetting heads rear 1 inch

  • Jetting heads rear 1/2 inch

  • Warthog

  • Desilt sledge

  • Desilt bomb

  • Large jetting nozze

  • Nozzle cleaning tools

  • Screwdrivers

  • Allen keys

  • Adjustable spamnner

  • Stilson

  • Remote (clean)

Vehicle Rear Operation

  • Are pressure gauges displaying an accurate reading?

  • Is 1/2 inch hose in good condition?<br>Check 10-15 metres of hose and blue leader hose

  • Are all switches clean with clear labels

  • Are all beacons working

  • Traffic cones available?

  • Chapter 8 road signs available

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.