7-7 Appendix 5.pdf

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PCS Bus Service
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W91QVN-21-R-0004
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APPENDIX V

SAFETY CHECKLIST

VEHICLE#________ WAS SUBJECTED TO A SAFETY CHECK ON _

BY_________________________

THE FOLLOWING ARE THE RESEULTS OF THE SAFETY CHECK.

l. LIGHTS SAT UNSAT

A. HEADLIGHTS

8. TURNSIGNALS

C. BRAKE LIGHTS

D. ACCESSORY LIGHTS

COMMENTS:

2. WHEELS

A. TIRES

B. B RIMS

C. LUGS

3. MIRRORS

A. REARVIEW

B. SIDE VIEW

4. LEAKS

A. EXHAUST

B. COOLANT

C. LUBRICANT

D. FUEL

E. HYDRAULIC

COMMNETS:

5. L.OOSE NUTS OR BOLTS

A PROPELLER SHAFTS

B. SHIFT LJNKAGES

C. U-BOLTS

6. SAFETY ITEMS

A FIRE EXTINGUISHER

B. FIRST AID KIT

C. WARNING TRAINGLE

OPERATOR: ________________________________

INSPECTOR: ________________________________

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