Remote Site Journey Plan & Vehicle Inspection

• Conducted on

  Date

• Driver Name

• Mobile Phone Number

• Vehicle Rego

• Vehicle Description

• From
  Address

• Client / Site

• Estimated KM to Site

• Journey Involves Off Road Travel

  YES

  NO

• Name of Contact at Remote Site

• Contact telephone Number

• Time of Departure

  Date

• Estimated Time of Arrival at Site

  Date

Additional Checks

• Sufficient Additional Water On board

  Yes

  No

  N/A

• Flashing Lights

  Yes

  No

  N/A

• Flags

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Radio

  Yes

  No

  N/A

• Second Spare Tyre Required

  Yes

  No

  N/A

• Jack

  Yes

  No

  N/A

• Wheel Brace

  Yes

  No

  N/A

• Mobile Phone (Battery Fully Charged)

  Yes

  No

  N/A

• Sufficient Fuel

  Yes

  No

  N/A

• Vehicle Prestart Check Completed

  Yes

  No

  N/A

• All Issues From Checklist Completed

  Yes

  No

  N/A

• Person to Be advise by phone / Text on Arrival at remote site

Vehicle Details

• Eastek Ltd for Chubb Hawkes Bay Electronic Security

• Drivers License Sighted and Current

  Yes

  No

• Odometer Reading

• Next Service Due

• Next Service Due KM

• WOF Expiration

• Rego Expiration

• Diesel RUC Expiration

Vehicle Inspection

• Vehicle Servicing is up to date (As per manufacturers servicing handbook

  Compliant

  Non-Compliant

  N/A

• Interior tidy and items appropriately restrained in the interior and exterior

  Compliant

  Non-Compliant

  N/A

• Horn working and seatbelts are in good condition

  Compliant

  Non-Compliant

  N/A

• Lights (headlights, parkers, blinkers ,reverse, and brake) Working

  Compliant

  Non-Compliant

  N/A

• Windscreen and Mirrors with no damage, chips or cracks

  Compliant

  Non-Compliant

  N/A

• Tyres / Wheels in good condition (Min 1.5mm tread across width)

  Compliant

  Non-Compliant

  N/A

• Spare tyre, tools and jack, in good condition and operational

  Compliant

  Non-Compliant

  N/A

• Fire extinguisher is secure and has been serviced

  Compliant

  Non-Compliant

  N/A

• Mobile phone handset holder and or system is installed for use

  Compliant

  Non-Compliant

  N/A

• Cargo Barrier correctly in place and secured

  Compliant

  Non-Compliant

  N/A

• Chemicals appropriately stored labeled and safety data sheets within 5 years

  Compliant

  Non-Compliant

  N/A

• Tools and equipment are fit for purpose and in good working condition ( including pressure/ electrical calibration)

  Compliant

  Non-Compliant

  N/A

• Roof Rack is secured and in good condition

  Compliant

  Non-Compliant

  N/A

• Ladders are appropriately tied down, secured and in good working condition

  Compliant

  Non-Compliant

  N/A

• Pressurized and non pressurized struts and other supports are fit for purpose and in good working condition (including vehicle bonnet and tailgate, canopy lids and windows toolboxes

  Compliant

  Non-Compliant

  N/A

• Reversing camera and or sensors are in good working condition

  Compliant

  Non-Compliant

  N/A

• All electrical equipment is in good working condition , tested and tagged. including portable 10ma RCD

  Compliant

  Non-Compliant

  N/A

• PPE available and in good working condition. Hardhat Issue date not greater than 2 years. Fall arrest - manufactures date is not greater than 10 years.

  Compliant

  Non-Compliant

  N/A

• LOTO Kit is complete and in good condition

  Compliant

  Non-Compliant

  N/A

• My Driving is on display sticker fitted and legible (On Badged vehicles)

  Compliant

  Non-Compliant

  N/A

• Motor Vehicle Glove box Guide available and current

  Compliant

  Non-Compliant

  N/A

• 4WD selector and Hub locks are operational

  Compliant

  Non-Compliant

  N/A

• First aid kit available and supplies current

  Compliant

  Non-Compliant

  N/A

• Ladders are in good and compliant condition, and ladder inspection is current

  Compliant

  Non-Compliant

  N/A