BLS Monthly Inspection

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Formed AI

BLS UNIT MONTHLY DETAIL SHEET

Date

EC Units

Mileage

VEHICLE

CLEANED

REPAIRS

INTERIOR CAB

Cleaned

Repairs

INTERIOR BOX

Cleaned

Repairs

EXTERIOR CAB

Cleaned

Repairs

EXTERIOR BOX

Cleaned

Repairs

CABINETS

OLD SEAL

NEW SEAL

UNIT #

A

OLD SEAL

NEW SEAL

UNIT #

B

OLD SEAL

NEW SEAL

UNIT #

C

OLD SEAL

NEW SEAL

UNIT #

D

OLD SEAL

NEW SEAL

UNIT #

E

OLD SEAL

NEW SEAL

UNIT #

EQUIPMENT

OLD SEAL

NEW SEAL

UNIT #

KED 1

OLD SEAL

NEW SEAL

UNIT #

HARE

OLD SEAL

NEW SEAL

UNIT #

SAGER

OLD SEAL

NEW SEAL

UNIT #

KTD

OLD SEAL

NEW SEAL

UNIT #

AIR SPLINTS

OLD SEAL

NEW SEAL

UNIT #

C-COLLAR BAG

OLD SEAL

NEW SEAL

UNIT #

TOOL BOX

OLD SEAL

NEW SEAL

UNIT #

MEDICATION KIT

OLD SEAL

NEW SEAL

UNIT #

MONITORING DEVICE

OPERATIONAL

CORRECT PADS

ALL CABLES

AED

OPERATIONAL

CORRECT PADS

ALL CABLES

SUCTION

OPERATIONAL

CORRECT PADS

ALL CABLES

BLS BAG

OLD SEAL

NEW SEAL

UNIT #

TOP

OLD SEAL

NEW SEAL

UNIT #

FRONT

OLD SEAL

NEW SEAL

UNIT #

RIGHT

OLD SEAL

NEW SEAL

UNIT #

LEFT

OLD SEAL

NEW SEAL

UNIT #

MISCELLANEOUS / ISSUES

Notes

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