COVA Daily Checksheet Date*Position in rotation: 1st Run2nd Run3rd RunVehicle #*Select valueCOVA 60COVA 61COVA 62Shift: *00:00-06:0006:00-18:0009:00-21:0018:00-24:00Crew 1:* First Last Crew 2:* First Last Additional Crew: Fuel Level:*Full3/41/21/4EmptyNYS Inspection Expiration?* Mileage:* Registration/Insurance Cards?*YesNoPortable Radios (2): Battery Charged, equipped with mic's*YesNoMaps, Fuel FOB, GPS, HazMat Book?YesNoSafety Vests (2)?YesNoVehicle lights working properly?*YesNoEmergency lights working properly?*YesNoSiren, Horn, Back-up alarm working properly?*YesNoDriver's compartment HVAC working*YesNoPatient Compartment HVAC working*YesNoAll equipment secured?*YesNoExterior Clean*YesNoInterior Clean?*YesNoFlares (6)? *YesNoJumper Cables Present?*YesNoTurn-out Jacket & Helmet (1 Set)?*YesNoFire Extinguisher Expiration date:* Oxygen M Tank PSI:* Oxygen D Tank PSI:* Oxygen- 1 Full, Sealed D Tank?*YesNoOnboard Suction working (tubing/yankauer)?*YesNoPortable Suction (tubing, yankauer, charged)?*YesNoGurney is made w/Linens?*YesNoGurney Battery Charged?*YesNoNC, NRB, Emesis Bag, Towel?*YesNoBLS Blue Bag stocked?*YesNoALS Red Bag Stocked & Locked?*YesNoAll cabinets properly stocked?*YesNoHeadblocks (3) Collars (3 ea size)?*YesNoBackboards (2) w/ straps (3)?*YesNoiPad charged?*YesNoComments:Upload a picture (if needed)?E-mail address, if you want an email copy.Send a copy of this checksheet to yourself Submit ChecksheetReset