Information
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DOT (Required) Annual Inspection
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Date and Time audit began
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Motor Carrier Operator Name And Address
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Inspector's Name
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The inspector meets the qualification requirements in section 396.19.
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Vehicle Type
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Vehicle Identification
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Fleet Unit Number
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Odometer reading at Inspection
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Photograph of Vehicle Being Inspected
Vehicle Components Inspected
1. Brake System
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a. Service Brakes
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b. Parking Brake System
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c. Brake Drums or Rotors
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d. Brake Hose
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e. Brake Tubing
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f. Low Pressure Warning Device
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g. Tractor Protection Valve
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h. Air Compressor
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I. electric Brakes
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j. Hydraulic Brakes
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k. Vacuum System
2. Coupling Devices
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a. Fifth Wheels
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b. Pintle Hooks
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c. Drawbar/Tow bar Eye
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d. Drawbar/Tow bar Tongue
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e. Safety Devices
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f. Saddle- mounts
3. Exhaust System
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a. Exhaust system leaking forward of or directly below the driver/sleeper compartment
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b. Bus exhaust system leaking or discharging in violation of standard
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c. Exhaust system likely to burn, char, or damage the electrical wiring, fuel supply, or any combustible part of the motor vehicle
4. Fuel System
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a. Visible leak
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b. Fuel tank filler cap missing
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c. Fuel tank securely attached
5. Lighting Devices
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All lighting devices and reflectors required by part 393 shall be operational
6. Safe Loading
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a. Parts of vehicle or condition of loading such that the spare tire or any part of the load or dunnage can fall onto the roadway
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b. Protection against shifting cargo
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c. Container securement devices on intermodal equipment
7. Steering Mechanism
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a. Steering wheel free play
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b. Steering Column
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c. Front axle beam and all steering components
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d. Steering gear box
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e. Pitman arm
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f. Power steering
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g. Ball & socket joints
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h. Tie rods & drag links
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i. Nuts
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j. Steering System
8. Suspension
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a. Any U-bolts, spring hangers, or other axle positioning parts cracked, broken, loose or missing resulting in shifting of an axle from its normal position.
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b. Spring assembly
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c. Torque, radius or tracking components
9. Frame
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a. Frame members
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b. Tire and wheel clearance
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c. Adjustable axle assemblies (sliding sub frames)
10. Tires
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a. Tires on any steering axle of a power unit
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b. All other tires
11. Wheels and Rims
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a. Lock or slide ring
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b. Wheels and rims
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c. Fasteners
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d. Welds
12. Windshield Glazing
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Requirements and exceptions as stated pertaining to any crack, discoloration or vision reducing matter (reference 393.60 for exceptions)
13. Windshield wipers
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Any power unit that has an inoperative wiper, or missing or damaged parts that render it ineffective
14. Other
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List any other condition which may prevent safe operation of this vehicle
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List any other condition which may prevent safe operation of this vehicle
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List any other condition which may prevent safe operation of this vehicle
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List any other condition which may prevent safe operation of this vehicle
SIGNATURES
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Comments?
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Repairs Completed?
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Signature of Mechanic Performing Annual vehicle inspection certifying this vehicle has passed all the inspection items in accordance with 49 CFR PART 396
