Information

  • Conducted on

  • Prepared by

  • Location
  • What is your contact phone number?

  • As the inspector I believe the information contained within this inspection is correct at the time of completing this inspection. I accept responsibility for having provided accurate information contained herein. The inspection is based on matters which were observed by or came to my attention as the inspector during the day/night however should not be relied upon as an exhaustive record.<br><br>I understand and accept that non-compliance with management directives and/or falsification of misleading information will have an associated consequence.<br><br>Do you agree and accept the statement above?

  • Do not proceed with the Inspection and contact your supervisor.

Vehicle Unit Information

  • Vehicle make

  • Vehicle model

  • Registration number

  • Unit identifier

  • Odometer reading

  • Are you the operator of this vehicle?

  • Stop completing this inspection and inform the operator they need to complete.

  • Are you appropriately licensed to operate this vehicle, and is your licence current?

  • Speak with Supervisor to arrange rectification

Vehicle Checklist

  • Are the tyres inflated, without visual damage, and tread level is above wear indicators?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are wheel nuts secure, reflected through alignment of wheel nut indicators?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Has a weekly check been conducted to ensure that the vehicle oil level is between the High / Low level indicators?

  • Top up if authorized.
    If not authorized, raise an EFMR. Speak with your Supervisor. Have your Supervisor validate and sign the EFMR. You must take a signed copy to the Plant department.

  • Is the vehicle in a clean and tidy state?

  • Speak with Supervisor to arrange rectification

  • Is the vehicle coolant level between High / Low level indicators?

  • Speak with Supervisor. Top up or raise EFMR as directed

  • Are the doors, latches, and bonnet damage free and operating correctly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the windows and windscreen damage free and operating correctly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the wipers and washers operating correctly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the seat belts and mirrors damage free and operating correctly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Is the reversing alert and horn working correctly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are all lights and indicators functioning as required

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the brakes and park brake working correctly?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Does the vehicle have a serviceable spare tyre, jack, and wheel brace?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Does your vehicle have any panel and / or body damage (including chips and scratches)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Is Ventia signage fitted and visible?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

Safety Equipment

  • Is there a fire extinguisher fitted to this vehicle?

  • If your vehicle is a MR or HR, immediately raise EFMR and speak with Supervisor.
    If your vehicle is a LV, speak with Supervisor to confirm requirement.

  • Add comments if you've submitted an EFMR previously, such as date and to who

  • Is the fire extinguisher within current test date (within six months), and the gauge has been visually checked to confirm fully charged (green)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Is there a first aid kit in this vehicle?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Is there a spill kit in this vehicle?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

Trailer

  • Will you be towing a Trailer?

  • Trailer registration

  • Trailer TARE (kg)

  • Trailer ATM (kg)

  • Unit identifier

  • Does the hitch and draw bar visually appear as serviceable (operable / no damage)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • You must include a photo of the hitch and bar assembly.

  • Do the tyres, rims, and wheel nut indicators visually appear serviceable (free from damages)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Is your trailer a Tandem Axle trailer?

  • You must include a photo of the left front wheel assembly

  • You must include a photo of the left rear wheel assembly

  • You must include a photo of the right rear wheel assembly

  • You must include a photo of the right front wheel assembly

  • Is your trailer a Single Axle trailer?

  • You must include a photo of the left side wheel assembly

  • You must include a photo of the right side wheel assembly

  • Does the vehicle have a serviceable spare tyre, jack, and wheel brace?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Have you performed a functional test of all lights and indicators?

  • Complete test of all lights and indicators now.

  • Are all lights and indicators working properly?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the shackles rated and visually serviceable (free from damage)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Are the safety chains rated and visually serviceable (free from damage)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

  • Do all electrical, air /hydraulic hoses visually appear serviceable (free from damage)?

  • Has an EFMR been raised previously for this issue?

  • Immediately raise an EFMR and speak with your Supervisor.
    Have your Supervisor validate and sign.
    You must take the signed copy to the Plant department.

EFMR

  • As a result of this inspection, have you raised a new EFMR?

  • Take a photo of the new EFMR. This photo is to be emailed to your supervisor directly as a separate email.

  • Add photo of the new EFMR
  • Add media

  • As a result of this inspection, have you identified an outstanding EFMR?

  • Take a photo of the existing EFMR. This photo is to be emailed to your supervisor directly as a separate email.

  • Take a photo of the existing EFMR
  • Add media

Sign

  • Who is your Supervisor?

  • INSPECTED BY:

  • SIGNED By signing this inspection I accept that failure to comply with direction from Ventia Utility Services may result in subsequent Performance Management.

  • This document aligns with TMS Form TS-PLT-FO-040 and is controlled via own Cloud and managed by HSEQ Team, this document is uncontrolled when printed.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.