Vehicle Health Check

• Client / Site

• Conducted on

  Date
• Location
  Address

• Vehicle Reg

• Make & model

Vision

• Front windscreen wipers and washers

  Good

  Fair

  Poor

  N/A

• Front windscreen

  Good

  Fair

  Poor

  N/A

• Rear windscreen wipers and washers

  Good

  Fair

  Poor

  N/A

• Rear window

  Good

  Fair

  Poor

  N/A

• Side windows

  Good

  Fair

  Poor

  N/A

• Doors

  Good

  Fair

  Poor

  N/A

• Wing mirrors

  Good

  Fair

  Poor

  N/A

Wheels & Tyres

• NSF Tyre Tread

• OSF Tyre Tread

• NSR Tyre Tread

• OSR Tyre Tread

• Brake connectors

  Good

  Fair

  Poor

  N/A

• Steering mounting

  Good

  Fair

  Poor

  N/A

• Wheel bearings

  Good

  Fair

  Poor

  N/A

• Front suspension bushes

  Good

  Fair

  Poor

  N/A

• Handbrake function

  Good

  Fair

  Poor

  N/A

• Brake pedal assembly

  Good

  Fair

  Poor

  N/A

• Master cylinder

  Good

  Fair

  Poor

  N/A

• Power steering unit

  Good

  Fair

  Poor

  N/A

• Pipe work & fittings

  Good

  Fair

  Poor

  N/A

Lights

• Headlights

  Good

  Fair

  Poor

  N/A

• Front side lights

  Good

  Fair

  Poor

  N/A

• Rear side lights

  Good

  Fair

  Poor

  N/A

• Front indicators

  Good

  Fair

  Poor

  N/A

• Rear indicators

  Good

  Fair

  Poor

  N/A

• Function of lights

  Good

  Fair

  Poor

  N/A

• Indicator fixings

  Good

  Fair

  Poor

  N/A

• Brake lights

  Good

  Fair

  Poor

  N/A

• Registration plate lights

  Good

  Fair

  Poor

  N/A

• Reversing light

  Good

  Fair

  Poor

  N/A

• Horn

  Good

  Fair

  Poor

  N/A

• Hazard warning

  Good

  Fair

  Poor

  N/A

Miscellaneous

• Engine oil level

  Good

  Fair

  Poor

  N/A

• Transmission oil level and filters

  Good

  Fair

  Poor

  N/A

• Coolant level

  Good

  Fair

  Poor

  N/A

• Radiator cap

  Good

  Fair

  Poor

  N/A

• Radiator / oil cooler / air conditioning condenser cleanliness

  Good

  Fair

  Poor

  N/A

• Fuel filters

  Good

  Fair

  Poor

  N/A

• Air filters

  Good

  Fair

  Poor

  N/A

• Cab filters

  Good

  Fair

  Poor

  N/A

• Fan belts

  Good

  Fair

  Poor

  N/A

• Fuel tank cap

  Good

  Fair

  Poor

  N/A

• Fuel leaks

  Yes

  No

  N/A

• Oil leaks

  Yes

  No

  N/A

• Coolant leaks

  Yes

  No

  N/A

• Battery levels

  Good

  Fair

  Poor

  N/A

• Battery fixings

  Good

  Fair

  Poor

  N/A

• Gear selector systems

  Good

  Fair

  Poor

  N/A

• Clutch pedal function

  Good

  Fair

  Poor

  N/A

• Exhaust system and fixings

  Good

  Fair

  Poor

  N/A

• Warning lights on

  Yes

  No

  N/A

• Any other faults found

  Yes

  No

  N/A

Declaration

• Enter date and time

  Date

• Name and signature of competent person carrying out inspection

  Sign