Information
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This form is the equivalent to Tyco form HSF6.2 issue 1
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Document No.
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Branch / Location
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Employees Name
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Vehicle registration number
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Type of vehicle
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Current Mileage
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Inspected by
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Location
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Date
General Vehicle Condition
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This form is the equivalent to Tyco form HSF6.2 issue 2 - Electronic Version 1.3
General Vehicle Condition
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Is the period or mileage since last service satisfactory?
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The recommended period between services for a vauxhall is 24 months or 20,000 miles.
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Are the tyres within legal limits?
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Are all the vehicle lights functioning correctly including indicators?
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Is the vehicle loaded correctly?
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Is the vehicle interior clean and is a no smoking sign fitted?
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Is the exterior of the vehicle clean and free of damage?
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Is the vehicle windscreen in an acceptable condition (check for bad cracks)?
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Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?
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Is the seat and head restraint position in line with company guidelines?
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Are the parking sensors operating correctly?
Personal Protective Equipment and Uniform
Personal protective equipment / uniform
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Are the employees safety shoes or boots in a satisfactory condition?
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Is the employees Safety helmet (head protection) in a satisfactory condition?
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Safety helmet issue date.
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Safety helmets to be renewed every four years irrespective of condition.
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Are the employees gloves (hand protection)in a satisfactory condition?
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Are the employees goggles / glasses (eye protection)in a satisfactory condition?
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Are the employees ear defenders (hearing protection)in a satisfactory condition?
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Is the employees hi-visibility waistcoat in a satisfactory condition?
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Is the employees dust mask (respiratory protection) in a satisfactory condition?
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Does the employee have PPE bag or suitable PPE containment?
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Is the employees first aid kit in a satisfactory condition?
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First Aid Kit Expiry Date
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Is the employees asbestos emergency kit in a satisfactory condition?
Documentation / Eyesight test
Documentation and eyesight test
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Does the employee have a valid identity card?
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Expiry date
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Does the employee hold a valid driving licence
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Does the employee have an up to date employee EHS handbook?
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Can the employee correctly read a vehicle number plate 20 metres away
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If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.
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Does the employee have a Car Safety Kit?
Health and Safety Passports
Health and Safety Passports
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Does the employee hold an ECS or CSCS card?
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Expiry date
Signature
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Auditors Signature
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Add signature
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Employees signature
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Add signature