Title Page
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Conducted on
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Driver Name
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Mobile Phone Number
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Vehicle Rego
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Vehicle Description
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From
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Client / Site
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Estimated KM to Site
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Journey Involves Off Road Travel
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Name of Contact at Remote Site
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Contact telephone Number
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Time of Departure
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Estimated Time of Arrival at Site
Additional Checks
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Sufficient Additional Water On board
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Flashing Lights
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Flags
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First Aid Kit
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Radio
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Second Spare Tyre Required
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Jack
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Wheel Brace
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Mobile Phone (Battery Fully Charged)
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Sufficient Fuel
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Vehicle Prestart Check Completed
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All Issues From Checklist Completed
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Person to Be advise by phone / Text on Arrival at remote site
Vehicle Inspection
Vehicle Details
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Eastek Ltd for Chubb Hawkes Bay Electronic Security
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Drivers License Sighted and Current
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Odometer Reading
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Next Service Due
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Next Service Due KM
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WOF Expiration
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Rego Expiration
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Diesel RUC Expiration
Vehicle Inspection
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Vehicle Servicing is up to date (As per manufacturers servicing handbook
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Interior tidy and items appropriately restrained in the interior and exterior
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Horn working and seatbelts are in good condition
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Lights (headlights, parkers, blinkers ,reverse, and brake) Working
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Windscreen and Mirrors with no damage, chips or cracks
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Tyres / Wheels in good condition (Min 1.5mm tread across width)
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Spare tyre, tools and jack, in good condition and operational
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Fire extinguisher is secure and has been serviced
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Mobile phone handset holder and or system is installed for use
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Cargo Barrier correctly in place and secured
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Chemicals appropriately stored labeled and safety data sheets within 5 years
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Tools and equipment are fit for purpose and in good working condition ( including pressure/ electrical calibration)
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Roof Rack is secured and in good condition
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Ladders are appropriately tied down, secured and in good working condition
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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
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Reversing camera and or sensors are in good working condition
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All electrical equipment is in good working condition , tested and tagged. including portable 10ma RCD
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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.
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LOTO Kit is complete and in good condition
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My Driving is on display sticker fitted and legible (On Badged vehicles)
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Motor Vehicle Glove box Guide available and current
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4WD selector and Hub locks are operational
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First aid kit available and supplies current
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Ladders are in good and compliant condition, and ladder inspection is current