Title Page
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Conducted on
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Prepared by
Vehicle Safety Inspection Form
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Driver Name
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Location or Sales Region
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Vehicle Make/ Model
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Registration Number
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Current Mileage
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Date of Inspection
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Date of Last Service
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Miles Since Last Service
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Signature
Tyre Checks
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Any Defects?
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Any Defects?
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Any Defects?
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Any Defects?
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Any Defects?
Lights
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NSF - Side Lights Any Defects?
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NSF - Dipped Beam Any Defects?
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NSF Main Beam Any Defects?
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NSF Daytime Running Lights (If applicable) Any Defects?
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OSF - Side Lights Any Defects?
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OSF - Dipped Beam Any Defects?
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OSF Main Beam Any Defects?
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OSF Daytime Running Lights (If applicable) Any Defects?
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NSR - Side Lights Any Defects?
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NSR Brake Lights Any Defects
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OSR - Side Lights Any Defects?
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OSR - Brake Lights Any Defects
Indicators
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NSF - Indicator Any Defects?
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NSR - Indicator Any Defects?
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OSF - Indicator Any Defects?
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OSR - Indicator Any Defects?
Vision
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Wipers Any Defects?
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Windsceen Any Defects?
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Windows Any Defects?
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Mirrors Any Defects?
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Lenses / Reflectors Any Defects?
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Number Plate Any Defects?
Fluids
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Oil levels
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Coolant levels
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Screenwash levels
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Any Additional Notes
Body Condition
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Any exterior damage?
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Any interior damage?
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Exterior Clean?
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Interior Clean?
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Please give details of any damage
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Is there any additional damage since the last check?
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Driver comments
Vehicle Safety Equipment
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Warning Triangle
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First Aid Kit
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Expiry Date of First aid contents?
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Tyre Depth Gauge
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Tyre Pressure Gauge
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Hi Vis Waistcoat
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Hi Vis Jacket
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Latex / Nitrile Gloves
Site Safety Equipment
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Hi Vis Waistcoat
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Hi Vis Jacket
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Safety Boots/Shoes
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Hard Hat
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Eye Protection
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Safety Gloves
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Ear Defenders
Documentation
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CSCS Card Expiry Date
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Valid Insurance Certificate including business use and courtesy car
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Valid Road Fund Licence
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MOT Certificate Where applicable
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Is driving licence within 10 year renewal period (Photo card type)
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Give details of any change to driving status (E.G. Road Traffic Offence, Medical Conditions)