VEDANTA LIMITED, LANJIGARH

Integrated Management System

LMV (Carrier) Inspection Checklist : Gate Entry /Pre Mobilization

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

Driver Name: Vehicle Registration No:

Driver 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 Driver's valid Driving License
2 Safety shoes, Jacket & Helmet
3 Tax Validity
4 Insurance Validity
5 Permit Validity
6 Fitness Validity
7 Pollution Under Control Validity
8 Seat belt for all seats
9 Tyre condition
10 Front horn
11 Reverse Horn
12 Front Light, Back & Brake Light
13 Both side Indicator
14 Wipers
15 No Ignition Problem
16 Both rear view mirror
17 Brake & Hand brake
18 2 nos of wheel chocks
19 Body & carrier condition
20 Vehicle documents copy with vehicle
21 Warning Triangle
22 Torch/flashlight, Jack & Tools
23 Reflective tape all sides
24 Fire extinguisher (1 kg DCP)
First aid kit(Antiseptic cream, Sterilized
25
dressing, Plaster, Gauze and bandage)
Vehicle is (Fit / Unfit)

Driver/Agency Name: Vehicle Inspector(VLL) Name

Signature Signature