AMR Dallas Random Unit Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicle Information

• Shift Identifier #: 123

• Fender #

• License Plate Number

• Vehicle Registration Sticker Current?

  Yes

  No

  N/A

• Vehicle State Inspection Sticker Current?

  Yes

  No

  N/A

• DSHS License Posted and Current?

  Yes

  No

  N/A

• Insurance Card Present and Current?

  Yes

  No

  N/A

• City of Dallas Vehicle Sticker Current?

  Yes

  No

  N/A

• Engine Oil Level Full?

  Safe

  At Risk

  N/A

• Generator Oil Full, if applicable

  Safe

  At Risk

  N/A

• Transmission Fluid Level Full?

  Safe

  At Risk

  N/A

• Engine Coolant Level Full?

  Safe

  At Risk

  N/A

Inspection Information

• Is vehicle "master book" being utilized with proper documentation throughout?

  Yes

  No

  N/A

• Vehicle Meets Minimum Stocking Requirements? If "no", list deficiencies found during random inspection...<br>**CHECK FOR EXPIRATIONS**

  Yes

  No

  N/A

• All deficiencies found were corrected? If no, explain.

  Yes

  No

  N/A

• Vehicle Remaining In Service?

  Yes

  No

  N/A

• NOTE: I have been informed that the inspection has been completed and made aware of any deficiencies.

• Inspector Signature

  Sign

• Crew 1 Signature

  Sign

• Crew 2 Signature

  Sign

• Crew 3 Signature (if applicable)

  Sign

• Once the inspection is complete, export the form in .pdf format to Kevin.Tipton@amr.net