|
SHIVGANGA DRILLERS LIMITED
MONTHLY AMBULANCE INSPECTION
|
|
| SR. NO. |
DESCRIPTION | CONDITION | REMARKS | |
|---|---|---|---|---|
| YES | NO | |||
| A VEHICLE DOCUMENTATION | ||||
| 1. | Vehicle Registration | |||
| 2. | Vehicle insurance Policy | |||
| 3. | Road Tax compliance | |||
| 4. | Vehicle Fitness certificate – form 38 | |||
| 5. | PUC certificate | |||
| 6. | Driver's Valid License | |||
| 7. | Vehicle inspection Tag | |||
| B AMBULANCE REQUIREMENT | ||||
| 8 | Yelp/wail Siren activated from driver panel? | |||
| 9 | All Mirrors are in place? | |||
| 10 | White Spot light over rear doors to illuminate rear loading zone? | |||
| 11 | Fire Extinguisher within reach of driver and outside the vehicle? | |||
| 12 | Seat belt for front seat available? | |||
| 13 | Rear seat available? | |||
| 14 | Rear door open fully? | |||
| 15 | Stretcher access clear to escort patient? | |||
| 16 | Stretcher has patient securing harness? | |||
| 17 | Pillow/blanket etc? | |||
| 18 | Storage space for equipment/material? | |||
| 19 | First Aid Kit | |||
| 20 | Anti-oscillation drip bottle holders? | |||
| 21 | Internal white light above stretcher area? | |||
| 22 | Full Oxygen cylinder with quick socket connection with flow meter/ humidifier? | |||
| C VEHICLE REQUIREMENT | ||||
| 23 | 4 wheel Drive | |||
| 24 | Fuel Meter | |||
| 25 | Fuel Level | |||
| 26 | Oil Meter | |||
| 27 | Oil Level | |||
| 28 | Horn / Reversing Horn | |||
| 29 | Head Light – Right | |||
| 30 | Head Light – Left | |||
| 31 | Head Light Deeper – Right | |||
| 32 | Head Light Deeper – Left | |||
| 33 | Front right | |||
| 34 | Front left | |||
| 35 | Back right | |||
| 36 | Back left | |||
| 37 | Parking Light | |||
| 38 | Hand Brakes | |||
| 39 | Hand Brake Light | |||
| 40 | Wiper / Washer | |||
| 41 | Emergency Tools | |||
| 42 | Any Leakage | |||
| 43 | General Condition | |||
| 44 | Spare Wheel | |||
| 45 | Jack & Tow Rope | |||
| 46 | Air Condition / Heater | |||
| 47 | Safety Triangle | |||
| 48 | Drinking Water Facility | |||
| 49 | Emergency light/torch | |||