Title Page

  • Document No.

  • BLR DOT Review:

  • Client / Site

  • Conducted on

  • Prepared by

  • Location


  • Branch Location:

  • Number of CDL Drivers

  • Number of non CDL drivers:

  • Log files 6 months plus current

  • Vehicle Daily Inspection files (DVIR) 90 days plus current

  • Driver Qualification file complete

  • Maintenance file and or records


  • Number of trucks:

  • Commercial annual inspection all trucks:

  • Valid registration

  • Valid insurance

  • IFTA Sticker and license

  • BLR decals installed both sides

  • BLR US DOT number installed both sides

Securement gear/ equipment

  • 3/8 chain (min 6600 WLL)

  • 3/8x1/2 binders ( min 9200 WLL)

  • 2" cargo straps

  • Height stick

  • Emergency cones

  • Wheel chalks

Issues needing addressed:

  • Recommendation:

  • Signature :

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.