CHECKLIST FOR HEAVY VEHICLE

INSPECTION
DATE: CAMPUS:
COMPANY OR OWNER:
TYPE OF VEHICLE (Agricultural tractor, loader, forklift, backhoe, bulldozer):
VEHICLE PLATE: __________________________ MODEL:_________________________
BRAND:_________________________________
REGULAR DRIVERS: 1. ______________________________________________
2.___________________________________________ 3._____________________________________
4._______________________________ 5. _______________________________________

To complete this form, follow the following instructions and mark as appropriate:
(√) IF THE PARAMETER TO BE VERIFIED COMPLIES AND IS FUNCTIONAL
(X) IF IT DOES NOT COMPLY OR IS NOT WORKING WELL
(N\A) IF NOT APPLICABLE.
Write down the problems found and the actions to be taken in the comments box.
STATE
SECURITY PARAMETER TO VERIFY (√) Complies. OBSERVATIONS
(X) Does not comply.
(N\A) Not Applicable.
OIL LEVEL
WATER LEVEL
BRAKES
BRAKE FLUID LEVEL
OPERATION STEERING
DASHBOARD
SEAT BELT
MAIN AND REVERSE WISH
BACKUP SIGN
SEAT
WINDSHIELD WIPER
RIGHT REARVIEW MIRROR
LEFT REARVIEW MIRROR
CENTER REARVIEW MIRROR
DOOR OPERATION
WINDOWS, GLASS
CHASSIS
FUEL TANK
HIGH LIGHTS
LOW LIGHTS
BRAKE LIGHTS
TAILLIGHTS
TURN SIGNALS
TAIL LIGHT PASTE
HEADLIGHT PASTE
DIRECTIONAL LIGHT PASTE
CLEANLINESS
PAINT
WHEELS WITHOUT CUT, WITHOUT BULGES AND
WITHOUT WEAR
ROAD EQUIPMENT (CAT, CROSSBOARDS, TACOS)
FIRST AID KIT
FIRE EXTINGUISHER ( ) POUNDS PQS
HYDRAULIC OR LUBRICATION SYSTEM WITHOUT
OBVIOUS LEAKS
NAME OF WHO PERFORMS THE INSPECTION
(DRIVER):
OBSERVATIONS