#490118- Passenger Vehicle Pre-Operational Equipment Checklist

Inspection Date: *

Agent Name: *

Location: *

Shift: *

If other, precise:

*Starred items requires GSE to pick up equipment. For all other items, deliver the equipment to GSE. *

Any issues found with the following items will require tagging the equipment with GSE Work Order Form 041240216, taking it out of service and notifying GSE immediately. THE PIECE OF EQUIPMENT IS NOT BE USED UNTIL GSE EVALUATES IT AND RETURNS IT TO SERVICE. *

Checklist *

PassFailMissingAt GSEReported to GSEYesNoNot Applicable
Visual Inspection: Remove all FOD/trash from unit.
*Brakes: Place foot on brake, place vehicle into drive, vehicle should move. If brakes feel soft or if vehicle moves while brake is engaged, tag the equipment, remove it from service immediately and notify GSE.
Parking Brake: With operator on vehicle, engage parking brake with vehicle in neutral. Put transmission in drive. If vehicle moves, tag the equipment, remove if from service immediately and notify GSE.
Seat/Seatbelt: If driver's seat belt is missing or malfunctioning, the vehicle must not be operated until repaired by GSE. If equipped with a passenger seat and the passenger seat belt is missing or malfunctioning, no passengers are allowed to ride until repaired by GSE.
Seat/Seatbelt: Check condition and security of seat for safe vehicle operation. Check to ensure all seatbelts in the operator cabin are secure and operational. If a seatbelt is missing or malfunctioning, tag the equipment as inoperable and take it out of service immediately. Notify GSE.
Tool Box (if equipped): Check security of any structurally attached tool box. If tool box contains parts or consumables, ensure they are appropriately separated.
Steering: While avoiding other obstacles in the operation, drive the vehicle a short distance. Turn the wheel to the right and then to the left. If the steering is stiff or feels like it is binding or if the vehicle is slow to react, tag the equipment, remove it from service immediately and notify GSE.
Hitch Assembly (if equipped): Check hitch for any sharp edges or burrs or for broken or missing parts. Check the retraining spring for is missing from the hitch, tag the equipment, remove it from service and notify GSE.
Cab & Doors: Visually check the condition of the body, cab and doors of the vehicle for any missing or broken parts or for any parts hanging from the vehicle (e.g., bumpers, running boards, railings, etc.). If the item has the potential to cause injury or damage, tag the equipment, take it out of service immediately and notify GSE.
Sharp Edges That may Pose a Risk of Injury: Visually check the condition of the body, cab and doors of the vehicle for any missing or broken parts or for any parts hanging from the vehicle (e.g., bumpers, running boards, railings, etc.). If the item has the potential to cause injury or damage, tag the equipment, take it out of service immediately and notify GSE.
Oil: Park the equipment on a level area and shut engine off. Wait a couple of minutes to let the oil flow down to the bottom of the engine. Take out the oil dipstick. Wipe the dipstick with a clean rag or tissue. Then stick it back all the way down into its holder. Remove the dipstick again and check the oil level. Normally the oil level should be at the "Full" mark, add appropriate oil type if not (DO NOT OVERFILL).
Lights (All Service Lights): Turn lights on. Check for headlight and taillight operation. Place ignition switch in "On" position and depress brake pedal have someone else verify operation of brake lights, report any problems to GSE. Inspect turn signals if equipped. Check all service lights.
Visual Inspection of Tires: Inspect for the following and notify GSE if you find: Visually check the tires for inflation (do they look low?), if you can see part of the belt showing through the tread or tire tread is bald, Look for any gouges or missing tread.
Fuel: Verify that adequate fuel is in the tank and that fuel cap is present and properly seals the fuel tank.
Horn: If horn does not work notify GSE.
Seat for Tears & Holes: Verify that the seat is in good condition with no exposed wires or splinters (if wooden).
Service Required? Was unit removed from service and GSE properly notified?

Notes: