SAFETY, OCCUPATIONAL HEALTH AND ENVIRONMENTAL MANAGEMENT SYSTEM

VEHICLE CHECK LIST

DRIVER:

INITIAL KM: FINAL KM: START TIME:

DATE: VAN OR TRUCK:

MARK: MODEL: YEAR:

B: GOOD M: BAD M/A: NOT APPLICABLE

ITEM DESCRIPTION B M N/A STATUS ITEM DESCRIPTION

VALID DRIVER'S LICENSE EXTINGUISHER

DOCUMENTATION

MANDATORY INSURANCE UP TO DATE BOTIQUIN

TECHNICAL REVISION CERTIFICATE TRIANGLES (CONES)
GAS CERTIFICATE BACK-UP ALARM
MAINTENANCE PROGRAM BARROT

ACCESSORIES
ALTAS WHEEL WRENCH
LOW REFLECTIVE TAPE
BACKWARDS PERTIGA
VIRAJE BALIZA
LIGHTS

EMERGENCY SEAT BELT

THIRD BRAKE LIGHT COMMUNICATION RADIO/ CELLULAR
PARKING INDICATOR CLOCKS
PATENT WINDSHIELD WIPER
CABIN INTERIOR WEDGE SET
PERDIGAL LIGHT ENGINE OIL
LEFT FRONT RADIATOR WATER
RIGHT FRONT TRANSMISSION OIL
LEVELS

LEFT REAR HYDRAULIC OIL

INSIDE LEFT FUEL
TIRES

RIGHT REAR HYDRAULIC CYLINDERS (LEAKS)

INSIDE RIGHT HYDRAULIC HOSES (LEAKS)
OPERATOR

REPLACEMENT LIC. MUN. PER DAY (CLASS___)

BOLTS INTERNAL LICENSE
PRESSURE LBS. (AIR) DEFENSIVE DRIVING COURSE
PARABRISA STABILIZERS
VIDRIOS

REAR WINDOW (REAR GLASS) SWIVEL ARM

LEFT DOOR ACCESS STAIRS
GENERAL

RIGHT DOOR OPERATIONAL SYSTEM

MIRRORS

LEFT SIDE PIN/JOINT SET

RIGHT LATERAL POLES/WIRES
INTERIOR OF THE CABIN HOOK
HOOK LATCH
REMARKS:
PERFORMED BY APPROVED BY

NAME: NAME:

POSITION: POSITION:

SIGNATURE: SIGNATURE:
TURNOVER:

TIME OF TERMINATION:

PATENT:

B M N/A STATUS
REVIEWED BY

NAME:

POSITION:

SIGNATURE:
 Lm
Code : PB-REG-SSOMA-008
SAFETY, OCCUPATIONAL HEALTH AND ENVIRONMENTAL MANAGEMENT SYSTEM
Version : 01
F. of Aprob: 20-11-2016
CHECK LIST OF VEHICLE HNOSS.A.C.
Page : 1 of 1

DATE: VAN OR TRUCK:

DRIVER: TURNOVER:
INITIAL KM: FINAL KM:
BR M DESCRIPTION BR M DESCRIPTION B R M DESCRIPTION
Left headlight
Parking brake
SOAT Property Card Right rear light
Steering system
Tool case Right front directional
Clutch system
Emblems Front left directional Rear right
Tires
Moons directional Rear left directional
Wheel stud
Plates from () Post () Emergency flashers
Spare tires
Gas cap Dashboard lights
Windshield
Radiator cap Brake lights
Wiper blades
Oil cap Living room lights
Safety belt
Brake Fluid Cap Third headlamp lights
Hydraulic jack and lever
Belts Circulina
Wheel wrench
Rearview Mirror
Horn
Right Mirror Locking lugs
Back-up alarm
Left Mirror Fire extinguisher
Service brakes
Right headlight Safety triangle
First Aid Kit

Good: No action needed Fair: Possible problem Bad: Needs action

Note:

Signature

Name