HTML Preview Vehicle Safety Checklist page number 1.
HS04-031B(1-08)
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:
Vehicle Number ______________________________ Date _______________
Yes No
Are all departmental vehicles subject to State licensing requirements equipped with the
following items in good operating condition:
Adequate rearview mirrors?
o o
Safety belts?
o o
Windshield wiper blades and uid?
o o
Horn?
o o
Correctly adjusted headlights?
o o
Brakes with adequate stopping power?
o o
Emergency brake?
o o
Turn/directional signals?
o o
Good tires with adequate tread and correct pressure?
o o
Oil and coolant levels?
o o
Brake lights?
o o
Taillights?
o o
License plate light?
o o
Tight mufer system?
o o
Properly serviced re extinguisher?
o o
Intact windshield, with no cracks?
o o
Is all seating in the vehicle secured to the frame?
o o
Is there an Automobile Liability ID Card located in the glove
compartment or elsewhere in the vehicle?
o o
Are appropriate notices posted in each vehicle as a reminder
that all employees and their passengers are required to wear
seat belts?
o o
Have all employees been instructed on safe backing
practices?
o o
Have employees been informed of what actions to take in the
event they are involved in a vehicle accident?
o o
Have employees been informed of appropriate safety
guidelines when hauling loads?
o o
Employee Signature
Supervisor’s Signature