Veolia Daily Vehicle Report ( Version 3 )

• Unit / Fleet Number

• Conducted on

  Date

• Registration Number ( Add Media )

  Media

• Workers Name

• Drivers Licence ( Add Photo )

  Media

• Trailer # 1 Registration Number ( Add Media )

  Media

• Trailer #2 Registration Number ( Add Media )

  Media

• Trailer #3 Registration Number ( Add Media )

  Media

Pre-Start Checklist - ALL ARE MANDATORY

• 01 - Outstanding Faults

  Repaired

  Booked in for repair

  Not Applicable

• 02 - Safety Check

  No Obvious Defect

  Fault Identified

  Not Applicable

• 03 - Oil and Coolant

  No Obvious Defect

  Fault Identified

  Not Applicable

• 04 - Inside Cab ( Add Media )

  Media

• 05 - Lights, Beacons and Reflectors

  No Obvious Defect

  Fault Identified

  Not Applicable

• 06 - Wheels and Tyre's ( check indicators )

  No Obvious Defect

  Fault Identified

  Not Applicable

• 07 - Body and Equipment ( Add Media of any Panel Damage / Defects )

  Media

• 08 - Safety Equipment

  No Obvious Defect

  Fault Identified

  Not Applicable

• 09 - Equipment / Site Specific Items

  No Obvious Defect

  Fault Identified

  Not Applicable

• 10 - NZ Specific Items

  No Obvious Defect

  Fault Identified

  Not Applicable

• 11 - Road users up to date ( Add Media )

  Media

• 12 - Wof / Cof up to date ( Add Media )

  Media

• The Truck/Vehicle must not be driven if a fault has been identified unless specifically authorised by Manager/Supervisor. ( Needs to sign below ) this does not exonerate operators from infringements / fines issued by enforcement officers.

• Manager/Supervisor to sign to authorise use

  Sign

Worker's Pre-Start Declaration

• I Certify that ( Print Name )

• I am Fit for work

• I have the appropriate, Valid drivers licence and appropriate PPE for operation of this Vehicle

• I have conducted the above Pre-Start Checklist and i am satisfied the Vehicle is Safe and ready to operate

• Workers Signature

  Sign

Post Trip Check List - ALL ARE MANDATORY

• Tyres

  No Obvious Defect

  Fault Identified

  Not Applicable

• Wheel Nut Indicators

  No Obvious Defect

  Fault Identified

  Not Applicable

• Lights

  No Obvious Defect

  Fault Identified

  Not Applicable

• Beacons

  No Obvious Defect

  Fault Identified

  Not Applicable

• Leaks (Oil/Liquid) (Truck /Body /Tank /Rear door Seals)

  No Obvious Defect

  Fault Identified

  Not Applicable

• Damage ( Add Media )

  Media

• Fuel Added ( in Litres )

• Add Blue Filled ( In Litres )

• Oil Added ( In Litres )

• Air Tanks Drained

  YES

  NO

• Battery Isolater Engaged

  YES

  NO

• Clean Windscreen

  YES

  NO

• Clean Cab ( Add Media )

  Media

• Truck Empty ( Add Media )

  Media

• The Truck / Vehicle must not be driven until faults have been corrected by a competent repair or scheduled and authorized to confirm that any items deferred do not affect safe operation

Vehicle Condition Report (To Be Completed if Faults are Identified)

• 01 - Engine

• 02 - Transmission

• 03 - Brakes

• 04 - Suspension/Steering

• 05 - Body/Hydraulics

• 06 - Electrical

• 07 - Wheels/Tyres

• Wheels/ Tyres ( Indicate on Road repairs, Tyre damage or wheel nut movement )

• 08 - Cab/Chassis

• 09 - Accessories

• 10 - Other ( State )

Workers Post Trip Declaration

• I Certify that ( Print Name )

• I Have reported all faults in the appropriate section above and notified the supervisor or Authorised Person

• Workers Signature

  Sign

• Odometer End

• Hour Meter End

VLO/Supervisor Debrief and Review

• I have reviewed this form and am satisfied that any required maintenance or safety related items have been initiated

• VLO/Supervisor Name and Signature

  Sign