ZZZ 123 - duplicate

• Document No.

• Audit Title

• Enter vehicle VIN Number

• Enter vehicle Registration Number

• Enter Vehicle Call Sign

• Enter vehicle kilometer reading

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Vehicle Certificate of fitness and Registration

• Is Certificate of Fitness (COF) disk visible on windscreen?

  Yes

  No

  N/A

• Is License Disk visible on windscreen and current?

  Yes

  No

  N/A

• Does registration number on front and rear number plates correspond with license disk?

  Yes

  No

  N/A

vehicle body and paintwork

Engine compartment

• Is Engine compartment clean?

  Yes

  No

  N/A

• Is break fluid level correct?

  Yes

  No

  N/A

• Is clutch fluid level correct?

  Yes

  No

  N/A

• is water level correct?

  Yes

  No

  N/A
Outside of vehicle

• Are there any scratches visible on paintwork?

  Yes

  No

  N/A

• Are there any dents visible on body?

  Yes

  No

  N/A

• Are all door hinges and latches fully opertional?

  Yes

  No

  N/A

• Are all vehicle lights fully operational?

  Yes

  No

  N/A

• Are all rims free of damage?

  Yes

  No

  N/A

• Are all tyres in good condition without any damage?

  Yes

  No

  N/A

• Is spare wheel present and without damage?

  Yes

  No

  N/A
Driver cab

• Are all window mechanisms and latches fully operational?

  Yes

  No

  N/A

• Are both driver cab seat belts fully operational?

  Yes

  No

  N/A

• Are all dashboard lights fully operational?

  Yes

  No

  N/A

• Is immobiliser fully operational?

  Yes

  No

  N/A

• Is central locking fully operational?

  Yes

  No

  N/A

• Is radio CD fully operational?

  Yes

  No

  N/A

• Are heater and Air-conditioner systems fully operational?

  Yes

  No

  N/A

• Is steering wheel in correct position and is play on steering wheel correct?

  Yes

  No

  N/A

• Is handbrake fully operational?

  Yes

  No

  N/A

Branding on Vehicle

Front of Vehicle

• Is the red "EMERGENCY VEHICLE" (in reverse) Decal present on the bonnet and according to NTC911 specification?

  Yes

  No

  N/A

• Is the "NETCARE" sign present on the bonnet and according to NTC911 specification?

  Yes

  No

  N/A

• Are there 2 diagonal reflective orange stripes available on left and right side of the bonnet and according to NTC911 specification?

  Yes

  No

  N/A

• is the white "082911" present on the windscreen and according to NTC911 specification?

  Yes

  No

  N/A

• Driver door and right front fender

Driver door and front fender

• Are there 2 diagonal reflective orange stripes present on right fender and in line with orange stripes on bonnet and according to NTC911 specification?

  Yes

  No

  N/A

• Are there 7 diagonal orange reflective stripes evenly spaced present on the driver door and according to NTC 911 Specification?

  Yes

  No

  N/A

• Is the "SA FLAG" present on the front fender and according to NTC911 specification?

  Yes

  No

  N/A

• Is "VODACOM" Red stached logo with icon present on the driver door and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the driver door and according to NTC 911 specification?

  Yes

  No

  N/A
Right sliding door

• Is the "NETCARE 082 911" Logo 'without 24hr emergency service' present on the right sliding door and right rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the right sliding door` and according to NTC911 specification?

  Yes

  No

  N/A
Right rear panel

• Is the right window shading done correct and according to NTC911 specifications?

  Yes

  No

  N/A

• Is the yellow "082 911" present on right rear window and according to NTC 911 specification?

  Yes

  No

  N/A

• Are there 5 diagonal reflective yellow stripes present, equally spaced and according to NTC 911 specification?

  Yes

  No

  N/A

• Is the "AVIS FLEET SERVICES" logo present on the right rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Are there 8 red dots present on the right rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the right rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the vehicle call sign present on the right rear panel and according to NTC911 specification?

  Yes

  No

  N/A
Back doors

• Is the back window shading done correct and according to NTC911 specifications?

  Yes

  No

  N/A

• Is the yellow "082 911" present on the back windows and according to NTC 911 specification?

  Yes

  No

  N/A

• Is the "NETCARE" Logo present on the back windows and according to NTC 911 specification/

  Yes

  No

  N/A

• Is the NTC 911 website address in white present on back windows and according to NTC 911 specification?

  Yes

  No

  N/A

• Is the "NETCARE 082 911" Logo 'with 24hr emergency service' present on the right back door and according to NTC911 specification?

  Yes

  No

  N/A

• Is "VODACOM" Red stached logo with icon present on the left back door and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective line present on both back doors below numberplate and according to NTC 911 specification?

  Yes

  No

  N/A

• Are red and white reflective chevron stripes present on both back doors above rear bumper and according to NTC 911 specification?

  Yes

  No

  N/A
Left rear panel

• Is the left window shading done correct and according to NTC911 specifications?

  Yes

  No

  N/A

• Is the yellow "082 911" present on left rear window and according to NTC 911 specification?

  Yes

  No

  N/A

• Are there 5 diagonal reflective yellow stripes present, equally spaced and according to NTC 911 specification?

  Yes

  No

  N/A

• Is the "AVIS FLEET SERVICES" logo present on the left rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Are there 8 red dots present on the left rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the left rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the vehicle call sign present on the left rear panel and according to NTC911 specification?

  Yes

  No

  N/A
Left sliding door

• Is the "NETCARE 082 911" Logo 'without 24hr emergency service' present on the left sliding door and right rear panel and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the left sliding door` and according to NTC911 specification?

  Yes

  No

  N/A

• Passenger door and left front fender

Passenger door and front fender

• Are there 2 diagonal reflective orange stripes present on left fender and in line with orange stripes on bonnet and according to NTC911 specification?

  Yes

  No

  N/A

• Are there 7 diagonal orange reflective stripes evenly spaced present on the passenger door and according to NTC 911 Specification?

  Yes

  No

  N/A

• Is the "SA FLAG" present on the front fender and according to NTC911 specification?

  Yes

  No

  N/A

• Is "VODACOM" Red stached logo with icon present on the passenger door and according to NTC911 specification?

  Yes

  No

  N/A

• Is the yellow reflective strip present on the bottom of the passenger door and according to NTC 911 specification?

  Yes

  No

  N/A

Emergency Lights, Siren, interior lights and inverter installation.

• Emergency light installation

Emergency lights

• Is correct light bar fitted in front?

  Yes

  No

  N/A

• Is front LED light bar installation straight and according to NTC 911 specification?

  Yes

  No

  N/A

• Are correct LED flasher light units installed in grill? <br>

  Yes

  No

  N/A

• Are grill flasher lights installed straight and according to NTC 911 specification?

  Yes

  No

  N/A

• Is correct mini LED bar installed at the rear of the vehicle?

  Yes

  No

  N/A

• Is mini LED bar installation in correct position, straight and according to NTC 911 specification?

  Yes

  No

  N/A

• Are there 2 LED Flasher lights installed at the rear inside the vehicle?

  Yes

  No

  N/A

• Are all LED lights operational?

  Yes

  No

  N/A

• Siren installation

Siren

• Is siren installed according to NTC 911 specification?

  Yes

  No

  N/A

• Is siren operational?

  Yes

  No

  N/A

• Is the PA system operational?

  Yes

  No

  N/A

• Emergency light, siren and PA system control panel

light and siren control panel

• Is control panel installed in correct position according to NTC 911 specification?

  Yes

  No

  N/A

• Is control panel installation staight?

  Yes

  No

  N/A

• Is the dash board free from any damage due to control panel instalation?

  Yes

  No

  N/A

• Is the PA microphone present and installed properly according to NTC 911 specification?

  Yes

  No

  N/A

• Inverter installation

Inverter

• Is the inverter installed underneath the passenger seat?

  Yes

  No

  N/A

• Is the inverter tested and operational?

  Yes

  No

  N/A

• Is the auxiliary battery installed underneath the passenger seat?

  Yes

  No

  N/A
Interior lighting

• Are there 5 interior LED light strips installed according to NTC 911 specification?

  Yes

  No

  N/A

• Are all lights installed straight without any sharp edges?

  Yes

  No

  N/A

• Are installation neat and tidy?

  Yes

  No

  N/A

• Are interior light switch installed correctly and fully operational?

  Yes

  No

  N/A

Tracker and Navman Installation

• Insert NAVMAN serial number

• Is tracking installed correctly and operational?

  Yes

  No

  N/A

• Is driver recognition tagging system installed correctly and operational?

  Yes

  No

  N/A

E-fuel Instalation

• Is e-fuel system installed correctly and operational?

  Yes

  No

  N/A

• Are toll card available and current?

  Yes

  No

  N/A

• Insert toll card number if applicable

• Are fuel card available, correct and current?

  Yes

  No

  N/A

• Insert Fuel card number if applicable

Wiring and installations

• Are engine compartment area free of any loose wires or connections?

  Yes

  No

  N/A

• Are auxiliary battery installed in such a way that no short circuit can occur?

  Yes

  No

  N/A

• Are installation free of any loos wires?

  Yes

  No

  N/A

• Are all wiring sleeved correctly?

  Yes

  No

  N/A

• Are all wires channeled correctly or in trunking?

  Yes

  No

  N/A

• Are all drilled holes for wiring sealed off after installation to prevent water leaks and rust?

  Yes

  No

  N/A

• Are the vehicle free from any damage that occurred during installation done?

  Yes

  No

  N/A

Ambulance conversion

Patient compartment

• Are there a fire extinguisher installed?

  Yes

  No

  N/A

• Are the fire extinguisher in service date?

  Yes

  No

  N/A

• Are dustbin installed in correct position?

  Yes

  No

  N/A

• Are yellow safety handle installed and secured properly in position against the roof at the back?

  Yes

  No

  N/A

• Ambulance Floor and stretcher

Floor

• Are floor rubberized properly in all areas to ensure infection control?

  Yes

  No

  N/A

• Are stretcher tray manufactured and installed correctly according to NTC 911 specification?

  Yes

  No

  N/A

• Are stretcher bracket installed correctly and straight?

  Yes

  No

  N/A

• Are stretcher mechanism working correctly?

  Yes

  No

  N/A

• Is stretcher fully operational?

  Yes

  No

  N/A

• Is stretcher stepper/protector plate on bumper bend and fitted correctly?

  Yes

  No

  N/A

• Is park assist sensor still operational after installation of stretcher stepper plate on bumper?

  Yes

  No

  N/A

• Portable Oxygen bunker behind passenger seat

Portable oxygen bunker

• Is portable oxygen bunker installed in correct position behind passenger seat in crew cab area?

  Yes

  No

  N/A

• Is bolt mechanism installed operating correctly?

  Yes

  No

  N/A

• Is side entry door able to open and close without any difficulty or restrain?

  Yes

  No

  N/A

• Is top flap working correctly without causing damage to passenger seat?

  Yes

  No

  N/A

• Are all hinges fitted properly and straight?

  Yes

  No

  N/A

• Is bunker designed to house x2 2l oxygen cylinders?

  Yes

  No

  N/A

• Double crew seats

Crew seat

• Are double crew seat installed in correct position to ensure free movement of driver seat and space for crew member to treat patient?<br>

  Yes

  No

  N/A

• Are correct high back rest seats installed as per NTC 911 specification?

  Yes

  No

  N/A

• Are arm rest on crew eat in the correct poition?

  Yes

  No

  N/A

• Are the 3 point safety belts installed on both crew seats and fully operational?

  Yes

  No

  N/A
Equipment bunker

• Is the equipment bunker lid properly bent and installed?

  Yes

  No

  N/A

• Is hinges on bunker lid straight and installed properly?

  Yes

  No

  N/A

• Does lid close properly?

  Yes

  No

  N/A

• Is gas rider stabiliser installed on equipment bunker lid and is it fully operational?

  Yes

  No

  N/A

• Is side entry door at the back of the bunker installed correctly?

  Yes

  No

  N/A

• Does side entry door open and close without any difficulty or restrain?

  Yes

  No

  N/A

• Is bolt on side entry door installed straight and fully operational?

  Yes

  No

  N/A

• Are there 2 seat cushions installed correctly on the equipment bunker lid?

  Yes

  No

  N/A

• Are there 2 back rests installed correctly against left inner wall?

  Yes

  No

  N/A

• Are there 2 retractable lap belts installed against the left inner wall and fully operational?

  Yes

  No

  N/A

• Long cabinet against right inner wall

Long cabinet

• Are bolt mechanisms installed straight and fully operational without difficulty or restrain?

  Yes

  No

  N/A

• Are cabinet doors installed properly and straight?

  Yes

  No

  N/A

• Are all hinges installed straight and and properly?

  Yes

  No

  N/A

• Are stopper mechanisms installed to ensure that lids are unable to be pushed inwards to prevent damage?

  Yes

  No

  N/A

• is there a double analogue flow regulator installed properly and in a straight position without any leaks?

  Yes

  No

  N/A

• Are there 2 x 3 prong plugs installed against right inner panel and fully operational?

  Yes

  No

  N/A

• Is there 1 x 2 pin plug installed straight against right inner panel and fully operational?

  Yes

  No

  N/A

• Are the interior light switch installed in correct position and straight and fully operational?

  Yes

  No

  N/A

• Are there 2 x 12 volt sockets installed and fully operational against right inner panel and fully operational?

  Yes

  No

  N/A

• Are there 6 x strap brackets installed in the correct position and properly secured?

  Yes

  No

  N/A

• Are there 3 x securing straps fitted to ensure safe securing of equipment?

  Yes

  No

  N/A

• Are there 2 x yellow safety handles installed in correct position and secured properly on the left cabinet?

  Yes

  No

  N/A
Oxygen bunker

• Are oxygen brackets installed correctly?

  Yes

  No

  N/A

• Are securing screws installed properly?

  Yes

  No

  N/A

• Are High pressure oxygen regulator installed properly and without leaks?

  Yes

  No

  N/A

• Are high pressure oxygen hose installed properly and neatly? from oxygen bunker to flow meter?

  Yes

  No

  N/A

• Auditor notes

• Signature of auditor

  Sign

• Select date

  Date