Page 6 of 10
0156
COMPLIANCE
Interior Continued
.................................................................................................................................
YES
.......
NO
........
NA
L. Flooring
...................................................................................................................................................
..........
.........
Gaps and seams......................................................................................................................................
..........
.........
Rolledupedgeswhere necessary...........................................................................................................
..........
.........
Securely glued .........................................................................................................................................
..........
.........
Cot holders securelymounted..................................................................................................................
..........
.........
Aluminum step, trim, front edge trim, and rear threshold .........................................................................
..........
.........
M. Kit tree/ shelves
......................................................................................................................................
..........
.........
Securelymounted....................................................................................................................................
..........
.........
Appropriate straps andbelts ....................................................................................................................
..........
.........
Fit and finish.............................................................................................................................................
..........
.........
N. Coat hooks
..............................................................................................................................................
..........
.........
O. Interior decal package
...........................................................................................................................
..........
.........
P. Fire extinguishers
..................................................................................................................................
..........
.........
#Of extinguishers?_______
Approved locations?
........................................................................................................................
..........
.........
Securelymounted
..............................................................................................................................
..........
.........
Retentionstrapsound ( belt or
metal strap)
...........................................................................
..........
.........
Q. Sharps, tissueandgarbagecontainers
...............................................................................................
..........
.........
R. ALS compartment (Interior
....................................................................................................................
..........
.........
Doors flush and aligned ...........................................................................................................................
..........
.........
Fit and finish.............................................................................................................................................
..........
.........
Shelves and straps...................................................................................................................................
..........
.........
S. CPR seat
.................................................................................................................................................
..........
.........
Fit and finish.............................................................................................................................................
..........
.........
Seat beltsboltedand complete
........................................................................................................
..........
.........
Operation and function
.....................................................................................................................
..........
.........
T. Spare tire and equipment
......................................................................................................................
..........
.........
Tire securelymounted..............................................................................................................................
..........
.........
Jack, crank andwrench included (location?__________________________) .......................................
..........
.........
U. Portableoxygenbracket
.......................................................................................................................
..........
.........
#Of tanks?______
Securelymounted
..............................................................................................................................
..........
.........
Retentionstrapssound ( belt or
metal strap)
.........................................................................
..........
.........
COMPLIANCE
6. Electrical Functions Inspection
.........................................................................................
YES
.......
NO
........
NA
A. Console
...................................................................................................................................................
..........
.........
NOTE: If a step is incomplete circle
O
the initial blank in
red
pen.
Thiswill be thenotification to thedownstreamwork center(s) that this stepstill needs tobe completed.
