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LIGHT TRUCK INSPECTION FORM

Equipment Model (Specify) :

Registration No. : Operator Name :

Identification / Plate No : ID No :

Date and Time of Inspection : Certificate No :

Location : Company :

First Inspection Second Inspection Third Inspection


S/No. Items Inspected
Pass Fail Pass Fail Pass Fail
1 Head lights, Turn indicators, Break light Function.

3 Windscreen / Window clear.

4 Wipers/Mirrors in good condition.

5 Rotating Beacon Function.

6 License plate visibility.

7 Triangular sign available.

8 Interior Housekeeping.

9 Tool Kit

10 First Aid Kit

11 Government / 3rd Party Certification provided (if required)

12 Tire Condition (Damage, Cracks, Inflated, worn out)

13 Backup Alarm/ Horn Function.

14 Wind Screen free of damages.

15 Fire extinguisher fitted and changed.

16 Speedometer, Coolant temp gauge functioning.

17 Chassis free of damage.

18 Seat belt properly functioning.

19 Brake system / Hand brake function.

20 Base plate condition.

21 Engine oil/Coolant level.

22 Engine oil/Coolant leakages.


Inspected By:

Subcontractor Heavy Equipment Inspector


(Sign/Date) (Sign/Date) (Sign/Date)

Contractor Vehicle / Mobile Equipment Inspector


(Sign/Date) (Sign/Date) (Sign/Date)
Remarks:
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Subcontractor Company: Sticker Number Issued (If pass)

Noted by Contractor HSSE Manager