Vehicle Safety Checklist

The following checklist is intended to assist employees who drive for a living in determining the safety of the vehicle within his/her operation. Any"no"answer should be cause for concern and corrective action. Prior to each out-of-town trip and at least once a week. Drivers should complete the following checklist.Are all department vehicles subject to State licensing requirements equipped with the following items in good operating condition:

Q1:Adequate rearview mirrors?

YES
NO

Q2:Safety belts?

YES
NO

Q3:Windshield wiper blades and fluid?

YES
NO

Q4:Horn?

YES
NO

Q5:Correctly adjusted headlights?

YES
NO

Q6:Brakes with adequate stopping power?

YES
NO

Q7:Emergency brake?

YES
NO

Q8:Turn/directional signals?

YES
NO

Q9:Good tires with adequate tread and correct pressure?

YES
NO

Q10:Oil and coolant levels?

YES
NO

Q11:Brake lights?

YES
NO

Q12:Taillights?

YES
NO

Q13:License plate light?

YES
NO

Q14:Tight muffler system?

YES
NO

Q15:Properly serviced fire extinguisher?

YES
NO

Q16:Intact windshield, with on cracks?

YES
NO

Q17:Is all seating in the vehicle secured to the frame?

YES
NO

Q18:Is there an Automobile Liability ID Card located in the glove compartment or elsewhere in the vehicle?

YES
NO

Q19:Are appropriate notices posted in each vehicle as a reminder that all employees and their passengers are required to wear seat belts?

YES
NO

Q20:Have all employees been instructed on safe backing practices?

YES
NO

Q21:Have employees been informed of what actions to take in the event they are involved in a vehicle accident?

YES
NO

Q22:Have employees been informed of appropriate safety guidelines when hauling loads?

YES
NO

Q23:Vehicle Number:

选项1

Q24:Date:

选项1

Q25:Employee Signature:

选项1

Q26:Supervisor's Signature:

选项1
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Vehicle Safety Checklist
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