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ADMIN-602 :; ADMIN-603 DAILY VEHICLE CHECKLIST Page 10 of 131 .' JOURNEY HAZARD Page 10 of 131 ASSESSMENT CARD Rev. April 2006 Rev.1 April 2006 Employee Name: Region/Business Unit: STOPI THINKI GOl Date: Time: Vehicle Calor: Date Vehicle MakelModel: Vehicle License Plate Number: Name Job: Job#: #of Miles Driven STOP Job: Job#: #of Miles Driven Job: Job#: #of Miles Driven Do I need to make this journey? ❑ Yes ❑ No Vehicle Mileage Stop ❑Stantec Vehicle Vehicle Mileage Stop ❑ Rental Vehicle STOP Total Miles Driven ❑ Personal Vehicle Where am I traveling? Perimeter Walk Around: OK NOT OK How long will I be driving? Check for signs of vandalism, negligence, damage or And do I have an ETA with a contact person? unusual conditions El ElAnd I communicated area hazards and safest mode of transport? Check all tires for excessive and unusual wear and proper inflation—include thespare are tire if it is easilyaccessible ElTHINK Check under vehicle for signs of leaking fluids ❑ ❑ Check wiper blades(Do they work?) ❑ ❑ How can I ensure that I have a safe journey? (Do they need replacement?) Check all light systems — brake, head, back-up, running, ❑ ❑ THINK turn si nals,emergency flashers Check to make sure doors, truck/toolbox lids, tailgates all Am I well rested an alert for the journey? ❑ Yes ❑ No open and close properly(Make sure you have keys to any toolboxes that you may need to access) ❑ ❑ THINK Check Gauges on Dashboard: OK NOT OK H Fuel Level ❑ E] is I done a vehicle walk around and ensured that the vehicle Oil light ❑ L]vel safe and ready for travel? E3Yes ❑ No Engine Coolant Temperature Gauge ❑ ❑ Service Indicator Lights ❑ ❑ ELEMENTS OF THE DRIVING STANDARD Battery Charge Indicator ❑ ❑ Has vehicle been inspected? ❑ Yes ❑ No Inside Vehicle: OK NOT OK • Will passengers be transported? ❑ Yes ❑ No Make sure seatbelts are present for all who will be riding inElHas cargo been secured? LJYes ❑ No the vehicle 0 a Driver's License Is current? ❑ Yes ❑ No Secure all cargo in the vehicle so that items will not become * Appropriately rested and alert? ❑ Yes ❑ No projectiles in the event of sudden stops or collisions . Journey risks have been identified? ❑ Yes ❑ No Adjust the seat position,rearview and side mirrors ❑ ❑ 0 Seatbelts are in working order? ❑ Yes ❑ No Adjust temperature controls,vents,radio,etc. ❑ ❑ 0 Medically fit for driving? ❑ Yes ❑ No Notify the vehicle manager or rental company if you feel that any deficiencies are unsafe and DO NOT drive the vehicle! HAVE A SAFE TRIPI Signature: DRIVING IS RISKY A TEC Consulting Corporation Attachment 6