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Document No: DIV-HSE-100-00

Date Revised: 05 January 2021


Title: HSE Checklist
Owner:

VEHICLE CHECKLISTS
Responsible Person: Vehicle Registration No:

Respond Yes/No or NA (Not Applicable) in columns below

EXTERNAL INSPECTION (visual inspection only) Date Date Date Date Date Date

1. Tyres in good condition

2. Water level correct? (Radiator & windscreen)


3. Oil level correct? (Power steering, brake fluid &
engine oil)
4. Are there any visible oil leaks?

5. Are there any visible fuel leaks?

6. Windscreen wiper blades in good condition?

7. Seat belts in good condition?

8. Rear view and side mirrors in good condition?

9. Hooter in a good condition?


10. Do ALL vehicle light work? (Head lights, flickers
(front & back), reverse light, brake lights, etc.)
11. Is there a spare wheel, and in a good condition?
12. Are car jacks & spanners in good operating
condition?
13. First aid kits fully replenished?
14. Fire-fighting equipment serviced annually and in
good working order?
Corrective Action Required or Additional remarks

User Signature Date:

Site Foreman Signature: Date:

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