BLR Driver Review

• Driver Name:

• Conducted on

  Date

• Unit numbers:

• Vehicle Year, Make, Model.

• VIN Number

• Submitted To:

Driver Information

• Driver name:

• Medical card expiration:

• Proper and valid license

  Yes

  No

  N/A

Unit information

• Valid and proper registration

  Yes

  No

  N/A

• Valid and proper insurance

  Yes

  No

  N/A

• IFTA sticker and License (if required)

  Yes

  No

  N/A

• Unit numbers displayed (both sides)

  Yes

  No

  N/A

• Company decals displayed both sides

  Yes

  No

  N/A

• Annual inspection currant

  Yes

  No

  N/A

SAFETY & PROJECT MANAGEMENT

• Accident kit

  Yes

  No

  N/A

• Spare fuse and bulbs

  Yes

  No

  N/A

• First Aid kit is complete and items within the expiration date?

  Yes

  No

  N/A

• Fire extinguisher mounted with current inspection tag?

  Yes

  No

  N/A

• Height stick

  Yes

  No

  N/A

• 4 emergency cones

  Yes

  No

  N/A

• 1 set wheel chalks

  Yes

  No

  N/A

• Shovel

  Yes

  No

  N/A

• Broom

  Yes

  No

  N/A

INTERIOR OF VEHICLE

• Interior clean of trash and dirt?

  Yes

  No

  N/A

• Air/heat/defroster working

  Yes

  No

  N/A

• Windshield wiper working

  Yes

  No

  N/A

• Instrument panel is indicating properly?

  Yes

  No

  N/A

• Windshield and mirrors clean and free from cracks?

  Yes

  No

  N/A

• Please provide a photo of the interior.

  Media

EXTERIOR & MECHANICAL

• Backup lights?

  Safe

  At Risk

  N/A

• Belts & Hoses?

  Safe

  At Risk

  N/A

• Brake blow down test

  Safe

  At Risk

  N/A

• Low air pressure warning buzzer

  Yes

  No

  N/A

• Brake Botton pop out

  Yes

  No

  N/A

• All Fluid Levels?

  Safe

  At Risk

  N/A

• Oil

• Coolant

• Hydro oil level

• Axle hub oil level

• Visible Fluid Leaks?

  Safe

  At Risk

  N/A

• Emergency Flashers?

  Safe

  At Risk

  N/A

• Headlights?

  Safe

  At Risk

  N/A

• Tail Lights?

  Safe

  At Risk

  N/A

• Turn Signals?

  Safe

  At Risk

  N/A

• Horn?

  Safe

  At Risk

  N/A

• Steering & Alignment?

  Safe

  At Risk

  N/A

• Tire condition and pressure

  Safe

  At Risk

  N/A

• Windshield/Wiper Blades/Fluid?

  Safe

  At Risk

  N/A

CARGO & EQUIPMENT (LEAN)

• Chain and binder condition

• All equipment is secured & adequately stored?

  Safe

  At Risk

  N/A

• Truck is organized & free of excessive material?

  Safe

  At Risk

  N/A

PLEASE PROVIDE PHOTOS

• Driver's Side

  Media

• Passenger's Side

  Media

• Bed of truck

  Media

IF EQUIPPED WITH A TRAILER

• Valid Registration

  Yes

  No

  N/A

• Valid insurance

  Yes

  No

  N/A

• Trailer has been checked for proper connection to the vehicle?

  Safe

  At Risk

  N/A

• Brakes condition

  Yes

  No

  N/A

• Cargo Secure?

  Yes

  No

  N/A

• Lights/Marker Lamps?

  Yes

  No

  N/A

• Air lines/ air bags condition

  Yes

  No

  N/A

• Straps/Tie Downs/Chains/Binders

  Yes

  No

  N/A

• Trailer Tires & Pressure?

  Yes

  No

  N/A

• Trailer Platform Integrity?

  Yes

  No

  N/A

Signature

• Add signature

  Sign