Technician Quarterly Check With Car

• Technical Quarterly Checklist

• Technician Name

• Conducted on

  Date
• Location
  Address

Ladder

Ladder

• Make

• Height

• Type

• Ladder is clearly identified as industrial grade ladder

  Yes

  No

  N/A

• All pivoting points or rotating surfaces should be lubricated with silicone spray

  Yes

  No

  N/A

• Check all bolts and rivets are present & secure

  Yes

  No

  N/A

• Are there any splits/cracks in all surfaces of ladder

  Yes

  No

  N/A

• Are there any significant dents or bends in surfaces, or loose parts

  Yes

  No

  N/A

• Ropes on extension ladders are in good condition, not frayed & run freely

  Yes

  No

  N/A

• Catches on extension ladders are in good condition operate freely & show no excessive wear in the hinges, and are not bent or damaged

  Yes

  No

  N/A

• Ladder hinges are in good condition

  Yes

  No

  N/A

• Ladder braces are in good condition & are tight

  Yes

  No

  N/A

• Is there any delamination of surface ie caused by UV. – Any exposed fibres

  Yes

  No

  N/A

• Are the rungs straight, & secure

  Yes

  No

  N/A

• Do the rungs have non-slip treads

  Yes

  No

  N/A

• Non-slip feet fitted and are in good serviceable condition

  Yes

  No

  N/A

• Ladder weight limit clearly displayed

  Yes

  No

  N/A

• Check tread and front tread brace for cracks and whether it is secure and steady

  Safe

  At Risk

  N/A

• Check stiles if applicable for any cracks or if they are bent in any way

  Safe

  At Risk

  N/A

• Check spreaders for any cracks and if they are still properly attached

  Safe

  At Risk

  N/A

• Check horizontal brace for cracks and whether it is secure and steady.

  Safe

  At Risk

  N/A

• Check top cap to ensure that it is secure and not broken in any way

  Safe

  At Risk

  N/A

• Check the ladder is fitted with correct maintenance tag.

  Yes

  No

  N/A

• Comments

Fire Extinguisher

• Do you have a fire extinguisher in your vehicle

  Yes

  No

  N/A

• Please contact the store person to organise a fire extinguisher

Fire Extinguisher

• Fire Extinguisher Type

  ABE

  CO2

  Wet Chemical

• Was the fire extinguisher service/checked in the last 6 months

  Yes

  No

  N/A

• Is the Gauge still in Green

  Yes

  No

  N/A

• Are there any Dents or Rust marks on the bottle

  Yes

  No

  N/A

• Is it fitted with a Maintenance Tag, Anti Tamper Seal and Ring

  Yes

  No

  N/A

• If you have answer is negative to any of these questions, please contact the store person to organise a replacement

First Aid Kits

• Do you have a First Aid Kit in your PPE bag

  Yes

  No

  N/A

• Please contact the store person to obtain a first aid kit

• Is it still sealed

  Yes

  No

• Expiry Date

  Date

Does it contain the following

• Conforming Bandage 50mm x 1

  Yes

  No

  N/A

• Expiry Date

  Date

• Disposable Resuscitation Face Shield x 1

  Yes

  No

  N/A

• Eye Pad Single x 1

  Yes

  No

  N/A

• Expiry Date

  Date

• Gloves Latex Pair

  Yes

  No

  N/A

• Plain Clip Seal Plastic Bag Med x 1

  Yes

  No

  N/A

• Plain Clip Seal Plastic Bag SML x 1

  Yes

  No

  N/A

• Plastic Magnifier x 1

  Yes

  No

  N/A

• Plastic Strips Box of 50 x 1

  Yes

  No

  N/A

• Expiry Date

  Date

• Safety Pints Assorted PK12 x 1

  Yes

  No

  N/A

• Saline Sachets x 2

  Yes

  No

  N/A

• Expiry Date

  Date

• Splinter Probe Single Disp. x 1

  Yes

  No

  N/A

• Tape Paper 1.25CM x 5M x 1

  Yes

  No

  N/A

• Expiry Date

  Date

• Trafalgar First Aid Pamphlet

  Yes

  No

  N/A

• Triangular Band. Dips.

  Yes

  No

  N/A

• Expiry Date

  Date

• Tweezers x 1

  Yes

  No

  N/A

• Wound Dressing No.15 x 1

  Yes

  No

  N/A

• Expiry Date

  Date

• Wound Wipes x 2

  Yes

  No

  N/A

• Expiry Date

  Date

• Scissors x 1

  Yes

  No

  N/A

• If any of these items are missing or out of date, please contact the store person for a replacement first aid kit

PPE Kit

• Do you have a PPE kit

  Yes

  No

  N/A

• Please contact the store person to organise a PPE kit

Do you have the following items in your PPE kit

• Safety glasses clear lens

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Glasses Case

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Goggles

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Eyewash Bottle

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Hard hat

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Protective sun hat (Brim, Mesh, Safari)

  Yes

  No

  N/A

• Safety/High visibility vest

  Yes

  No

  N/A

• Ear muffs

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• Ear plugs

  Yes

  No

  N/A

• Respirators

  Yes

  No

  N/A

• Type of Respirators

  Select Disposable Respirator Disposable Respirator (P2) Full Mask Respirator Half Mask Respirator

  • Disposable Respirator
  • Disposable Respirator (P2)
  • Full Mask Respirator
  • Half Mask Respirator

Disposable respirators

• Is it kept in a sealed bag

  Yes

  No

  N/A

Disposable respirators (P2)

• Is it kept in a sealed bag

  Yes

  No

  N/A

Full Mask Respirator

• Is it kept in a lock tight bag

  Yes

  No

  N/A

• Is the mask cleaned after each use

  Yes

  No

  N/A

• Are the filters marked with the date the filter was fitted to the mask

  Yes

  No

  N/A

Half Mask Respirator

• Is it kept in a lock tight bag

  Yes

  No

  N/A

• Is the mask cleaned after each use

  Yes

  No

  N/A

• Are the filters marked with the date the filter was fitted to the mask

  Yes

  No

  N/A

• Sunscreen

  Yes

  No

  N/A

• Expiry Date

  Date

• Danger Tags - 'Do Not Operate' (Cardboard/Polyprop)

  Yes

  No

  N/A

• Lockout Kit

  Yes

  No

  N/A

• Gloves - Cotton

  Yes

  No

  N/A

• Are they in good condition

  Yes

  No

  N/A

• Barrier Tape

  Yes

  No

  N/A

• Bag

  Yes

  No

  N/A

• Disposable Overalls

  Yes

  No

  N/A

• Rigger Gloves

  Yes

  No

  N/A

• Are they in good condition

  Yes

  No

  N/A

• Waterproof Coat

  Yes

  No

  N/A

• Are they in good condition?

  Yes

  No

  N/A

• If you have answered no to any of the above PPE questions. Do you require any of this equipment

  Yes

  No

• Please contact store person to organise replacement PPE gear

Electrical

• Are all items used for work purposes tested and tagged and is the tag in date?

  Yes

  No

  N/A

LV Kit

• Do you have a low voltage rescue kit

  Yes

  No

  N/A

• Has the LV Kit been inspected within the last 6 months

  Yes

  No

  N/A

• Return to store person as soon as possible to be inspected

Test Equipment

• Do you have any Test equipment? e.g. Multi Meter

  Yes

  No

  N/A
Equipment

• Make

• Model

• Meter Class

• Has this been calibrated or tested in the last 6 months?

  Yes

  No

  N/A

• Contact the store person and take the equipment back to the warehouse to be calibrated or tested