SAFE Report

SAFE Report ID

Fault Details

Employee Name *

Date *

Fleet Number *

Site Address *

Risk Level *

Has this issue been reported previously? *

Fault issue

Please record a detailed description of the issue, being mindful that others must be able to understand the issue being reported. *

Please upload photos of the issue being reported

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Driver/Refueler Signature *

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Management Sign Off

Has this issue been rectified?

Please provide details below: If the repair is to be deferred, or to be monitored, please provide time frame of when the repair(s) will be carried out. If repair(s) is to be monitored, please also list upper limits that have been determined.

By signing this SAFE Report, i am declaring that this issue has been rectified, deferred, or is being monitored. The actions listed meet the requirements of the TechFuel Maintenance Management System.

Management Signature

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Date of Sign Off