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CÓDIGO OP-FM-03

INSPECCIÓN PREOPERACIONAL VEHICULO VERSIÓN 1

FECHA 8/29/2018

CONDUCTOR_________________________________ PLACA_________________ EMPRESA:_________________________KMS INICIAL________________KILOMETRAJE FINAL ________________

ITEM A MES:_________________________ AÑO:____________


ESTANDAR
INSPECCIONAR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
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Nivel de aceite del motor
Nivel de aceite hidráulico de la dirección
Nivel de liquido de frenos
Nivel de liquido refrigerante
Nivel de fluidos
Nivel de liquido del embargue
Nivel de liquido del parabrisas
Mangueras, tubos, conexiones ricotes
Ausencia de fugas
Llanta presión y labrado
Llanta de repuesto
Sistema de elevación de vidrios
Estado general del
Asiento, limpia brisas
vehículo
Cinturones de seguridad
Limpieza del vehículo
Espejos retrovisores
Caja de herramientas
Gato con vástago
Kit de carretera Triángulos o conos
Linterna
Cruceta
Botiquín dotado
Kit de emergencias Extintor de 5 LB
Kit ambiental de derrames
Tanque de
Sin fugas/ajustado/contapay ajustada
combustible
Luces altas
Luces bajas
Luz de frenado
Luz interna cabina
Luces de reversa
sistema eléctrico Luces de direccionales
Luz de parqueo
Velocímetro
Testigos
Alarma
Pito
Licencia de transito y pase
FUEC
Pólizas
Documentos
SOAT
vigentes
Revisión tecno mecánica
Preventiva
Tarjera de operación
Seguridad Social ARL EPS MES VIGENTE

1. Estriba B si el ítem a inspeccionar se encuentra en buen estado o M si se encuentra en mal estado o presenta un peligro para la actividad
2. El coordinador debe verificar que el formato se encuentra totalmente diligenciado.

3. Cuando se registra M, se debe reportar la deficiencia al propietario del vehículo quien debe reportar por dicha diferencia. Así mismo escribirle el numero de la observación correspondiente y la describe al reverso de este documento.

Firma ___________________________________ Nombre y apellido conductor ____________________________________________________ Fecha de entrega ____________


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