Title Page
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Vehicle identification number
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Conducted on
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Prepared by
Documentation
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Current Registration
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Current Insurance
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Current plate
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Pre-trip mileage
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Post-trip mileage
Vehicle lighting operation
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Head lamp hi/ low operation
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Fail location?
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Marker light operation
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Fail location?
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Turn signal operation
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Fail location?
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Clearance light operation
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Fail location?
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License plate light operation
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Interior cab lamp operation
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Cargo lamp operation
Vehicle Braking
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Front braking operation
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Symptoms
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Rear braking operation
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Symptoms
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Parking brake operation
Vehicle tread/tire condition
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Tire tread depth/condition
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Fail location?
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Front tire inflation
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Fail location?
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Rear tire inflation
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Fail location?
Windshield/Wipers condition
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Windshield clear/undamaged
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Fail location/type?
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Windshield wiper condition/operation
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Fail location?
Engine fluid condition
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Engine oil full/condition
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Low/Burnt/Discolored
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Transmission fluid full/condition
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Low/Burnt/Discolored
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Engine coolant full/condition
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Low/Burnt/Discolored
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Other fluids full/condition
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Type/Low/Burnt/Discolored
Safety equipment
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Fire extinguisher present/charged
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Description
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Road triangles/flares present
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Missing/damaged
Additional information/malfunction
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Description