[Insert operator name] No. Driver / Scheduler Name Driver TLIF Scheduler Medical Roster / Schedule / Fit for Duty Trip Sheets/ Course TLIF Course Certificates Safe Driving Plan Statement Work Diary Pages Completed Completed (Current Yes/No) (Date Range) Completed (Page Numbers) (Yes/No) (Yes/No) (Yes/No)
[Insert operator name] No. Driver / Scheduler Name Driver TLIF Course Completed (Yes/No) Scheduler TLIF Course Completed (Yes/No) Medical Certificates (Current Yes/No) Roster / Schedule / Safe Driving Plan (Date Range) Fit for Duty Statement Completed (Yes/No) Trip Sheets/ Work Diary Pages (Page Numbers)
201606-0322-nhvas-audit-summary-report.docx