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Republic of the Philippines

Department of the Interior and Local Government


BUREAU OF FIRE PROTECTION
Panay Fire Station - Capiz
Pob. Ilaya, Panay, Capiz
Tel. No. 620 7293 / 0961 778 7546
Email Add: panaybfp@gmail.com

(BFP6LD Form No. 1)

MOTOR VEHICLE DAILY SAFETY CHECKLIST

Vehicle Make & Model: ISUZU MORITA/ ENGINE 930 Plate Nr.: SBM - 714
Engine Nr.: 6BD1 - 376714 Chassis Nr.: JOR – 420- 3459919

STATUS REMARKS

____________ 1. Battery (17 plates) ______________________

____________ 2. Lights ______________________

____________ 3. Oil ______________________

____________ 4. Water ______________________

____________ 5. Brakes (HYDRAULIC TYPE) ______________________

____________ 6. Air ______________________

____________ 7. Gas (______ liters) ______________________

____________ 8. Engine ______________________

____________ 9. Tires (size _9.00-20_) ______________________

____________ 10. Power Steering ______________________

____________ 11. Horn/Siren ______________________

____________ 12. Directional Signals ______________________

____________ 13. Hydraulic System ______________________

Inspected by: Date and Time of Inspection


FTDO

CREW

Rank/Name/Designation

Noted by:

SFO2 Juliet B Delfn, BFP


Acting Municipal Fire Marshal

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