Weekly Van Safety Check

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Inspection Date/Time

  Date

• Team

• Type Ford Transit

  Select Nemo L200

  • Nemo
  • L200

• Reg

• Mileage

physical

• Dashboard hazard lights on?

  Yes

  No

  N/A

• Turn signals operational

  Yes

  No

  N/A

• Break lights operational

  Yes

  No

  N/A

• Head Lights

  Yes

  No

  N/A

• Tail Lights

  Yes

  No

  N/A

• Reversing Lights

  Yes

  No

  N/A

• Flashing Lights

  Yes

  No

  N/A

• Tyres in good condition

  Yes

  No

  N/A

• Horn work

  Safe

  At Risk

  N/A

• Vehicle body in good condition

  Yes

  No

  N/A

• Van clean and organized

  Yes

  No

  N/A

List any other action items that need to be corrected

• Enter/list issues here.

Signatures

• Employee

  Sign

• Manager

  Sign