ST FORS V1.1

• Engineer Name

• Conducted on

  Date
• Location
  Address

• Whilst on Southern Thermal business employees are required to complete this form prior to operation of any company owned vehicle as part of our FORS Registration. Completion of this form will check the road worthiness of the Vehicle and identify any potential malfunctions/defects which may cause a risk to the health and safety of the driver and other road users. This form must be submitted to our Fleet Operations Manager Brian Gilbertson (Brian.gilbertson@southernthermal.co.uk) on a daily basis. Any defects that prevent the vehicle being used shall be immediately reported.

• Enter Vehicle Reg No.

• Make

  Vauxhall

  Citroen

  Other

• Mileage

Electrics

• Heating and Ventilation System

  Pass

  Fail

  Needs Attention

• Main Beam

  Pass

  Fail

  Needs Attention

• Dipped Beam

  Pass

  Fail

  Needs Attention

• Side Lights

  Pass

  Fail

  Needs Attention

• Brake Lights

  Pass

  Fail

  Needs Attention

• Tail Lights

  Pass

  Fail

  Needs Attention

• Reverse Lights

  Pass

  Fail

  Needs Attention

• Indicators

  Pass

  Fail

  Needs Attention

• Hazard Lights

  Pass

  Fail

  Needs Attention

• Rear Fog Lights

  Pass

  Fail

  Needs Attention

• Interior Lights

  Pass

  Needs Attention

• Windscreen Washer

  Pass

  Needs Attention

• Wiper Blades

  Pass

  Needs Attention

• Reverse Alarm

  Pass

  Needs Attention

  Not fitted

• Horn

  Pass

  Needs Attention

• Radio/CD

  Pass

  Needs Attention

Body Work Exterior

• Drivers Side

  Media

• Comments

• Front of Vehicle

  Media

• Comments

• Passenger Side

  Media

• Comments

• Rear of Vehicle

  Media

• Comments

• Decals/Livery Intact

  Pass

  Needs Attention

• Windows/Windscreen

  Good

  Chipped (not in drivers view)

  Requires immediate attention (drivers view affected)

• Sliding Doors

  Pass

  Needs Attention

  Not fitted

• Rear Door

  Pass

  Needs Attention

• Rear Ladder/Roof Rack

  Pass

  Needs Attention

  Not fitted

Interior Condition

• Interior Overall Condition

  Clean & Tidy

  Dirty and untidy

• Seat Belts

  Pass

  Fail

  Needs Attention

• Interior Mirror

  Pass

  Fail

  N/A

Tyres - Condition

• Front

  Correctly Inflated, good condition

  Correctly Inflated, need replacement as approaching legal limit

• Rear (Visual)

  Correctly Inflated, good condition

  Correctly Inflated, need replacement as approaching legal limit

• Spare (Visual)

  Correctly Inflated, good condition

  Correctly Inflated, need replacement as approaching legal limit

• Wheel Brace

  Present

  Not Present

• Jack

  Present

  Not Present

Under Bonnet

• Cleanliness/Signs of any Leaks<br>

  Clean/No signs of any leaks

  Signs of Leaks present

• Oil Level (if topping up is required please ensure the correct grade of oil is used as per the manufacturers hand book instructions as engine damage could occur if incorrect oil is used)

  Correct Level on Dip Stick

  Oil Added

• Washer Fluid

  Checked and Satisfactory

  Checked and fluid added

• Coolant Level (if you have previously topped up the coolant level and are needing to do so on a regular basis please report issue to your line manager immediately)

  Checked and Satisfactory

  Checked and fluid added

• Brake Fluid Level

  Checked and Satisfactory

  Checked and fluid added

Other Detail

• Suspension in good working order

  Pass

  Needs attention

• Doors locking / unlocking correctly

  Pass

  Needs attention

• Vehicle Documentation Present and contains copies of mot certificate, vehicle insurance, waste carriers license certificate, valid tax disc, company liability insurance, vulnerable drivers policy, mobile phone policy and breakdown assistance information

  Present

  Not Present

• Warning Triangle

  Present

  Not Present

• No Smoking Signs

  Present

  Not Present

• Any other comments including suspected malfunctions or issues with vehicle

• Engineer Signature

  Sign