Servee Consultoria em Segurança do Trabalho

• Driver Name:

• Realizado em

  Date

• Truck number

• Trailer numbers

• Submitted To:

ADMINISTRATIVE

• Registration & insurance cards are current?

  Yes

  No

  N/A

• License plate and tags are current?

  Yes

  No

  N/A

SAFETY & PROJECT MANAGEMENT

• Emergency positioning beacon in vehicle

  Yes

  No

  N/A

• Emergency water supplies

  Yes

  No

  N/A

• First Aid kit is complete and items within the expiration date?

  Yes

  No

  N/A

• Fire extinguisher mounted with current inspection tag?

  Yes

  No

  N/A

• Emergency contacts list in truck

  Yes

  No

  N/A

INTERIOR OF VEHICLE

• Interior clean of trash and dirt?

  Yes

  No

  N/A

• Instrument panel is indicating properly?

  Yes

  No

  N/A

• Windshield and mirrors clean and free from cracks?

  Yes

  No

  N/A

EXTERIOR & MECHANICAL

• Backup lights?

  Safe

  At Risk

  N/A

• Belts & Hoses?

  Safe

  At Risk

  N/A

• Brakes? (Pedal Pressure)

  Safe

  At Risk

  N/A

• Visible Fluid Leaks?

  Safe

  At Risk

  N/A

• Emergency Flashers?

  Safe

  At Risk

  N/A

• Headlights?

  Safe

  At Risk

  N/A

• Tail Lights?

  Safe

  At Risk

  N/A

• Turn Signals?

  Safe

  At Risk

  N/A

• Horn?

  Safe

  At Risk

  N/A

• Steering & Alignment?

  Safe

  At Risk

  N/A

• Tyres & Pressure?

  Safe

  At Risk

  N/A

• Windshield/Wiper Blades/Fluid?

  Safe

  At Risk

  N/A

• undefined

CARGO & EQUIPMENT (LEAN)

• All equipment is secured & adequately stored?

  Safe

  At Risk

  N/A

• Truck is organized & free of excessive material?

  Safe

  At Risk

  N/A

IF EQUIPPED WITH A TRAILER

• Trailer has been checked for proper connection to the vehicle?

  Safe

  At Risk

  N/A

• Brakes if equipped?

  Yes

  No

  N/A

• Cargo Secure?

  Yes

  No

  N/A

• Lights/Marker Lamps?

  Yes

  No

  N/A

• Springs Appear OK?

  Yes

  No

  N/A

• Straps/Tie Downs?

  Yes

  No

  N/A

• Trailer Tires & Pressure?

  Yes

  No

  N/A

• Trailer Platform Integrity?

  Yes

  No

  N/A

Signature

• Add signature

  Sign