Vehicle Safety Checklist

The following checklist is intended to assist employees who drive for a living in determining the safety of the vehicle within his/her operation. Any"no"answer should be cause for concern and corrective action. Prior to each out-of-town trip and at least once a week. Drivers should complete the following checklist.


Are all department vehicles subject to State licensing requirements equipped with the following items in good operating condition:
Adequate rearview mirrors?
YES
NO
Safety belts?
YES
NO
Windshield wiper blades and fluid?
YES
NO
Horn?
YES
NO
Correctly adjusted headlights?
YES
NO
Brakes with adequate stopping power?
YES
NO
Emergency brake?
YES
NO
Turn/directional signals?
YES
NO
Good tires with adequate tread and correct pressure?
YES
NO
Oil and coolant levels?
YES
NO
Brake lights?
YES
NO
Taillights?
YES
NO
License plate light?
YES
NO
Tight muffler system?
YES
NO
Properly serviced fire extinguisher?
YES
NO
Intact windshield, with on cracks?
YES
NO
Is all seating in the vehicle secured to the frame?
YES
NO
Is there an Automobile Liability ID Card located in the glove compartment or elsewhere in the vehicle?
YES
NO
Are appropriate notices posted in each vehicle as a reminder that all employees and their passengers are required to wear seat belts?
YES
NO
Have all employees been instructed on safe backing practices?
YES
NO
Have employees been informed of what actions to take in the event they are involved in a vehicle accident?
YES
NO
Have employees been informed of appropriate safety guidelines when hauling loads?
YES
NO
Vehicle Number:
    ____________
Date:
    ____________
Employee Signature:
    ____________
Supervisor's Signature:
    ____________

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