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VEDANTA LIMITED, LANJIGARH

Integrated Management System

Pay loader-Dozzer Chain Type Checklist : Gate Entry /Pre Mobilization


Manufacture & Model Name :
Issue Date: Rev No. 02
Document No. : VLL/IMS/Safety/VD/19 Version: 01
27.05.2019 Rev Date: 27.05.2019
Date: Time: Agency /Transporter Name

Operator Name: Vehicle Registration No:

Operator Gate Pass No if any : Vehicle Gate Pass No if any :


Status
PASS (√)
SL No.

Rechecked
OBSERVATIONS FAIL (×) Defect found
Date & sign
Not applicable
(NA)
1 Valid Driving License (Heavy or Transport)

2 PPEs(Helmet, Reflective Jacket, Safety Shoes)

3 Tax Validity
4 Insurance Validity
5 Seat belt
6 Chain Condition
7 Front & Back Horn
8 Front Light,Back Light
9 No Ignition Problem
10 Both rear view mirror if cabin available
11 Brake & Hand brake
12 Body Conditions
13 Wiper if cabin is available
14 Beacon horn
15 No hydraulic leakage
16 Vehicle documents copy with vehicle
17 Torch/flashlight, Jack & Tools
18 Reflective tape all sides
19 Fire extinguisher (5 kg DCP)
First aid kit(Antiseptic cream, Sterilized
20
dressing, Plaster, Gauze and bandage)
Vehicle is (Fit / Unfit)

Driver/Agency Name: Vehicle Inspector(VLL) Name

Signature Signature

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