GENERAL CARGO VEHICLE INSPECTION

1. DRIVER AND VEHICLE DATA

Name: C.C. Age

No. Lic ence of Conduction: License restrictions: Defeats: Cate

EPS: ARL: AFP:

Header Plate: Model: Trailer plate:

Date I nspection : Number of compartments: Capacity Kg:

Transportation Company:
Type of cargo: Bulk: O Cross doking: O General: O Massive: O

Bodywork: Van: O Stakes: O Plank: O Container holder: O Tent: D

2. DOCUMENTATION AND DRIVER'S COMPETENCE

STATUS
CRITERIA REMARKS
B M N/A

1 The driver knows and complies with the Safety, Hygiene and Environment policy.

The driver has the appropriate personal protection elements: helmet, safety glasses, safety boots, long-sleeved
2
shirt.

3
The driver knows and has the Emergency Directory to use in case of accidents. He knows how to interpret it.
4 The driver knows and has the Emergency and Contingency Plan.

The driver has basic knowledge of Hazardous Materials Handling, Emergency Attention on highways for the
5
transportation of chemical products, Defensive Driving, Decree 1609/02 (Certification attached).

6 The driver has an EPS and ARL contribution form.

3. VEHICLE DATA
Vehicle Type: Mule tract: O Turbo: O Single: O Double troque: O Truck: O Other:
D
4. DOCUMENTS
Documents Number Vence Not Applicable
7 Vehicle Transit License

8 Trailer Registration
9 Compulsory Insurance (SOAT)
10 Contractual and Extracontractual Civil Liability Policy
11 Technical mechanical and gas inspection
12 Hydrostatic Test Certificate (maximum validity 2 years)
13 Black Light Certificate for fifth wheel (maximum validity 2 years)
14 Driver's Folder including emergency cards for chemicals transported, emergency telephone numbers, operating
procedures, travel plan.
5. CABIN VERIFICATION
STATUS
CRITERIA REMARKS
B M N/A

15 Smooth engine start-up and shutdown (HAG) TO TEST)

16 protected electrical installations
17 Covered batteries

18 Lights (HIGH, MEDIUM, LOW, DIRECTION lights, PARK, BRAKE, REVERSE)

19 3-point seat belts for driver and passengers passenger
20 Works Pito, including reverse Pito
21 Safety Brake
22 Central electrical switch / Master Switch
23 Crack-free panoramic glass
24 Rearview mirror on both sides and windshield in good condition, without obstructions
25 Exterior appearance (cleanliness)
26 Driver's seat and headrest
27 Exhaust covered

28 Exterior appearance (paint)

29 Breeze wipers, door opening handles, glass lifter.
30 Fifth wheel and quin ping (NO CRACKS, NO WELDING)
31 Back-up Alarm
32 Communication System
33 GPS

34 First Aid Kit

35 Indicator panel (fuel, temperature, oils, batteries, revolution)
36 Fuel Tank
37 Prevention and Safety Team (Road)
38 Address
39 91cms high cone
40 Flashlight
41 Cat

42 Toolbox
43 Notice of no passengers allowed
44 Transportadora company logo
45 Number UN

46 Order and cleanliness inside the cabin

6. For all trailers (vans, bodies or stakes, flatbeds or slabs, etc.), the following are required
 STATUS
CRITERIA REMARKS
B M N/A
Condition of the floor and interior of the trailer: Clean, free of stains, free of odors, free of moisture and no
47
evidence of food transport residues.

48 Condition of van doors (does not apply to flatbeds and container carriers).

49
Condition of frames (trailer legs or side supports) that are not bent, broken. Complete (settlement basis)
50 Anti-splash device (Dust cover)
51 Rear fender

52 Condition of the metal supports of the body or van.

7. EMERGENCY CARE KIT
(It must be verified that it is complete and in good condition).

STATUS
CRITERIA REMARKS
B M N/A

53 Safety glasses with side shields

54 Rhombus according to risk class
55 Rubber boots with steel toe cap
56 Nitrile and/or neoprene gloves
57 Neoprene apron
58 Respiratory mask with multipurpose cartridges (sealed storage)
59 Safety Glasses
60 Anti-spark plastic shovel
61 Reflective vest

62 Absorbent material (lime and/or sawdust) - oliophilic cloth

63 Contaminated waste storage bags and brush
64 Helmet with chinstrap
65 Harness and sling
66 Demarcation or isolation tape
67 20 lbs Multipurpose Extinguishers (minimum 2)
8. TIRES CONDITION (applies to all vehicles)

HEAD INSPECTION (footprint measurement in mm - MINIMUM STANDARD: Directional 3mm Traction 3mm) TOW TRAILER INSPECTION (footprint measurement in mm - STANDARD M

Applies to tract mules and minimules (skateboards). Applies to double, single, turbos and trucks.
 note: If you have 2 axles please place on the trailer end tires (not applicable: N/A).
RESULT OF THE REVIEW (Place Nr. of rim to be rotated or changed) RESULT OF THE REVIEW (Place Nr. of rim to be rotated
ROTATING TIRES ROTATING TIRES
CHANGE TIRES CHANGE TIRES
9. VERIFICATION OF VANS

43

COMPLIANCE: NON-COMPLIANCE:
COMPLIA NON-
O O
NCE: COMPLIANC
Mark with an x the damaged parts (holes, perforations) or contaminated parts (stains).

STATUS
OBSERVATIONS (The van and bodywork must be entered in order to detect possible light or water leaks. RESULT OF THE REVIEW
YES No NA
68 Cleanliness, deterioration, absence of sharp objects (screws, nails)
69 Evidence of transport of product for human or animal consumption
70 Water leaks
71 Door adjustment
72 Rear door gasket
73 Side door gasket
74 Rear door locks
75 Side door locks
 76 Stirrup

77 Material review for load securing (slings or straps with winch systems)
10. VERIFICATION OF BODYWORK OR STAKES
STATUS
CRITERIA REMARKS
YES No NA

78 Condition of the tent, not broken, belts and buckles in good condition.
79 King Ping Status
80 It has gas cylinder loading and unloading devices.
81 Trailer air and electrical connections
82 Chassis
83 Bicycle racks
84 Turn signals, stop, reverse, side, parking, stop, reverse, side lights
85 Electrical connections
86 Condition of carriage hatches

Mark with an (x) the damaged parts (holes or perforations, broken boards) or contaminated parts (stains)
Note: The image of the platform can be used to take note of the container holders and to check the spinning tops.

COMPLIANCE
CRITERIA REMARKS
YES NO N/A

After all of the above items have been verified, the compliance and approval of the vehicle for loading is determined?

The driver was given the basic notions of Decree 1609/02, Handling and Transportation of Dangerous Goods
Substances and Contingency Plan.
The driver received illustrative support brochures: Policies (corporate, road safety, health, hygiene, environment, alcohol and drugs) and Emergency Directory.
 PENDING DRIVER COMMITMENTS (applies for all vehicles)

Name of the person responsible for the

Driver's Name:
inspection:

Responsible signature: Driver's Signature

gory:

Remarks
INIMO: Traction (3mm)
etas.
_________
or change)

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