Information
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Prepared by
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Conducted on
Vehicle Information
Vehicle Information
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Truck Number
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mileage
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Exterior Front photo
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Exterior drivers side photo
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Exterior rear photo
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Exterior Passenger side photo
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Interior Passenger side photo (Both Doors Opened)
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Interior Drivers Side Photo (Both Doors Opened)
Cab Interior
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Window Operation
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Door Locks in working order
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Seatbelts in working order
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Interior Lights Work
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Hazard lights work
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Back-up Camera operational and adjusted properly
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All company forms present
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sales agreements
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Pre Application Notices
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Post Application Notices
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Ban Welcome Packets
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Seasonal Marketing Materials
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Printer in good condition and stored properly
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Heater and A/C working
Accident Packet/Emergency Products
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Insurance Card
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Incident Reports
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Accident Investigation Form
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Instruction Sheet
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UA Sign Off Form
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Concentra Location Form
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First Aid Kit Present and Stocked Properly
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Spill Kit
PPE
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Safety cone present and in good conditon
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Bump Cap/Hard Hat present and in working condition.
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Safety Glasses and Goggles present
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Respirator present and stored properly
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Extra Uniform
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Coveralls Present
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Spare Pair of work Boots. (Illinois only)
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Stinging Insect PPE Present and in good condition
Exterior
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Windows and windshield in good condition
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Windshield wiper working
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Turn signals working
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Headlights functional low and high beam
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Tail Lights & Brake Lights
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Tires in good condition
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Low Tread Life left
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Damaged tires
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Horn working
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Mirrors properly adjusted/convex mirrors installed
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Extension Ladder Properly Secured on vehicle
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Additional comments/observations or exterior damages noted attach photos below
Observation
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Add media
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Add observations/comments here.
Truck Bed
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products properly stored
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water containers labeled
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product containers labeled and sealed.
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Proper amounts of products present.
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Too much Product
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To little product
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Truck Cap Locks in working order
Signatures
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I hereby certify that all information is accurate and that an actual inspection was conducted.
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Auditor's Printed Name & Signature
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Technicians signature