Carroll White REMC - Monthly Vehicle & Trailer Inspection

• Conducted on

  Date

• Inspected by

• Vehicle or Trailer #

  Select 8-1 Chrysler Van 8-2 2017 Int. 4000 Series 4300 8-4 Dir. of Ops Truck 8-5 Ford Super Duty 8-7 2018 Int. 4300 Digger 8-8 2008 Int. Aerial 8-9 2017 Int. 4300 w/Aerial Device 8-10 Delphi Line Superintendent Truck 8-11 Ford Super Duty Digger 8-15 Ford Econoline Van 8-16 Ford Edge 8-17 2010 Int. Bucket Truck 8-18 2010 Ford 8-20 2012 Ford 8-21 Butler Reel Trailer 8-22 Small Red Reel Trailer 8-24 Large White Pole Trailer 8-25 Yellow Reel Trailer 8-200 Dump Trailer 91-1 2014 Int. Terex-Telect Derrick 91-2 2009 Ford Econoline Van 91-3 2009 Ford F250 4x4 Supercab 91-4 Chrysler Van 91-5 2018 Int. 4300 Digger 91-6 2009 Int. Terex HR50M Aerial 91-7 2016 Ford Super Duty 91-8 2017 Int. 4300 4X2 91-9 Mechanic's Truck 91-10 2011 Ford Expedition 91-12 2002 Ford 4x2 Dump Bed Super Duty 91-14 2002 Chevrolet Crew Cab 91-15 Energy Advisor's Van 91-16 2012 Ford Super Duty 91-17 CEO's Expedition 91-18 Mont. Line Superintendent's Truck 91-202 DBW Pole Trailer 91-204 LA Woods Trailer

  • 8-1 Chrysler Van
  • 8-2 2017 Int. 4000 Series 4300
  • 8-4 Dir. of Ops Truck
  • 8-5 Ford Super Duty
  • 8-7 2018 Int. 4300 Digger
  • 8-8 2008 Int. Aerial
  • 8-9 2017 Int. 4300 w/Aerial Device
  • 8-10 Delphi Line Superintendent Truck
  • 8-11 Ford Super Duty Digger
  • 8-15 Ford Econoline Van
  • 8-16 Ford Edge
  • 8-17 2010 Int. Bucket Truck
  • 8-18 2010 Ford
  • 8-20 2012 Ford
  • 8-21 Butler Reel Trailer
  • 8-22 Small Red Reel Trailer
  • 8-24 Large White Pole Trailer
  • 8-25 Yellow Reel Trailer
  • 8-200 Dump Trailer
  • 91-1 2014 Int. Terex-Telect Derrick
  • 91-2 2009 Ford Econoline Van
  • 91-3 2009 Ford F250 4x4 Supercab
  • 91-4 Chrysler Van
  • 91-5 2018 Int. 4300 Digger
  • 91-6 2009 Int. Terex HR50M Aerial
  • 91-7 2016 Ford Super Duty
  • 91-8 2017 Int. 4300 4X2
  • 91-9 Mechanic's Truck
  • 91-10 2011 Ford Expedition
  • 91-12 2002 Ford 4x2 Dump Bed Super Duty
  • 91-14 2002 Chevrolet Crew Cab
  • 91-15 Energy Advisor's Van
  • 91-16 2012 Ford Super Duty
  • 91-17 CEO's Expedition
  • 91-18 Mont. Line Superintendent's Truck
  • 91-202 DBW Pole Trailer
  • 91-204 LA Woods Trailer

• This inspection is being conducted on:

  Digger/Bucket Truck

  General Vehicle

  Trailer

• Vehicle or Trailer #

  Select 8-1 Chrysler Van 8-2 2017 Int. 4000 Series 4300 8-4 Dir. of Ops Truck 8-5 Ford Super Duty 8-7 2018 Int. 4300 Digger 8-8 2008 Int. Aerial 8-9 2017 Int. 4300 w/Aerial Device 8-10 Delphi Line Superintendent Truck 8-11 Ford Super Duty Digger 8-15 Ford Econoline Van 8-16 Ford Edge 8-17 2010 Int. Bucket Truck 8-18 2010 Ford 8-20 2012 Ford 8-21 Butler Reel Trailer 8-22 Small Red Reel Trailer 8-24 Large White Pole Trailer 8-25 Yellow Reel Trailer 8-200 Dump Trailer 91-1 2014 Int. Terex-Telect Derrick 91-2 2009 Ford Econoline Van 91-3 2009 Ford F250 4x4 Supercab 91-4 Chrysler Van 91-5 2018 Int. 4300 Digger 91-6 2009 Int. Terex HR50M Aerial 91-7 2016 Ford Super Duty 91-8 2017 Int. 4300 4X2 91-9 Mechanic's Truck 91-10 2011 Ford Expedition 91-12 2002 Ford 4x2 Dump Bed Super Duty 91-14 2002 Chevrolet Crew Cab 91-15 Energy Advisor's Van 91-16 2012 Ford Super Duty 91-17 CEO's Expedition 91-18 Mont. Line Superintendent's Truck 91-202 DBW Pole Trailer 91-204 LA Woods Trailer

  • 8-1 Chrysler Van
  • 8-2 2017 Int. 4000 Series 4300
  • 8-4 Dir. of Ops Truck
  • 8-5 Ford Super Duty
  • 8-7 2018 Int. 4300 Digger
  • 8-8 2008 Int. Aerial
  • 8-9 2017 Int. 4300 w/Aerial Device
  • 8-10 Delphi Line Superintendent Truck
  • 8-11 Ford Super Duty Digger
  • 8-15 Ford Econoline Van
  • 8-16 Ford Edge
  • 8-17 2010 Int. Bucket Truck
  • 8-18 2010 Ford
  • 8-20 2012 Ford
  • 8-21 Butler Reel Trailer
  • 8-22 Small Red Reel Trailer
  • 8-24 Large White Pole Trailer
  • 8-25 Yellow Reel Trailer
  • 8-200 Dump Trailer
  • 91-1 2014 Int. Terex-Telect Derrick
  • 91-2 2009 Ford Econoline Van
  • 91-3 2009 Ford F250 4x4 Supercab
  • 91-4 Chrysler Van
  • 91-5 2018 Int. 4300 Digger
  • 91-6 2009 Int. Terex HR50M Aerial
  • 91-7 2016 Ford Super Duty
  • 91-8 2017 Int. 4300 4X2
  • 91-9 Mechanic's Truck
  • 91-10 2011 Ford Expedition
  • 91-12 2002 Ford 4x2 Dump Bed Super Duty
  • 91-14 2002 Chevrolet Crew Cab
  • 91-15 Energy Advisor's Van
  • 91-16 2012 Ford Super Duty
  • 91-17 CEO's Expedition
  • 91-18 Mont. Line Superintendent's Truck
  • 91-202 DBW Pole Trailer
  • 91-204 LA Woods Trailer

• Please inspect each item indicating if the condition of the item is OK, Not OK, or Not Applicable.

• Are you conducting this inspection on a vehicle?

  Yes

  No

• Contains the following (Select All That Apply):

  Select Insurance Card Registration Form Operator's Manual Accident Reporting Guidelines DOT Inspection

  • Insurance Card
  • Registration Form
  • Operator's Manual
  • Accident Reporting Guidelines
  • DOT Inspection

• Windows

  OK

  Not OK

  N/A

• Windshield wipers

  OK

  Not OK

  N/A

• Mirrors

  OK

  Not OK

  N/A

• Housekeeping: (Dash, cab, and storage areas are clean and uncluttered)

  OK

  Not OK

  N/A

• Lights (including spot light, brake lights, directional light, etc.)

  OK

  Not OK

  N/A

• Reflectors

  OK

  Not OK

  N/A

• Roadside emergency triangular markers, flares, or other highway hazard warning devices

  OK

  Not OK

  N/A

• Tires

  OK

  Not OK

  N/A

• Wheels & Rims

  OK

  Not OK

  N/A

• Horn

  OK

  Not OK

  N/A

• Seat Belt

  OK

  Not OK

  N/A

• Brakes (including trailer brake connection, parking brake, emergency brakes)

  OK

  Not OK

  N/A

• Steering mechanism

  OK

  Not OK

  N/A

• Back-up Signal

  OK

  Not OK

  N/A

• Tools, materials, and cargo properly stored and secured

  OK

  Not OK

  N/A

• Protective guards, covers, or sheaths in place for sharp edges and points

  OK

  Not OK

  N/A

• Winch Cable and Ropes

  OK

  Not OK

  N/A

• Ground Clamps and Cables

  OK

  Not OK

  N/A

• Wheel Chocks (at least 2 on large trucks)

  OK

  Not OK

  N/A

• Outriggers and Outrigger Pads

  OK

  Not OK

  N/A

• Manufacturer's identification, capacity ratings, instruction placards, and/or decals are visible, permanent and legible

  OK

  Not OK

  N/A

• Oil or Hydraulic Leaks

  OK

  Not OK

  N/A

• Hydraulic Control

  OK

  Not OK

  N/A

• Auger/Shaft and Auger Strap

  OK

  Not OK

  N/A

• Remarks or Notes.

• Please inspect each item indicating if the condition of the item is OK, Not OK, or Not Applicable.

• Are there tools or equipment stored on or in the vehicle?

  Yes

  No

• Chain Hoist

  OK

  Not OK

  N/A

• Nylon Strap Hoist

  OK

  Not OK

  N/A

• Bull Dog Grips

  OK

  Not OK

  N/A

• Smooth Grips

  OK

  Not OK

  N/A

• Hand Lines

  OK

  Not OK

  N/A

• Transformer Block

  OK

  Not OK

  N/A

• Sling Ropes

  OK

  Not OK

  N/A

• Transformer Gin

  OK

  Not OK

  N/A

• Splicing Tools

  OK

  Not OK

  N/A

• Bolt Cutters

  OK

  Not OK

  N/A

• Shovels

  OK

  Not OK

  N/A

• Spades

  OK

  Not OK

  N/A

• Tamps

  OK

  Not OK

  N/A

• Rock Bar

  OK

  Not OK

  N/A

• Cant Hook

  OK

  Not OK

  N/A

• Cordless Tools, i.e. Crimper, Cutters, Etc

  OK

  Not OK

  N/A

• Extension Cords

  OK

  Not OK

  N/A

• Ladder

  OK

  Not OK

  N/A

• Climbing Rope(s)

  OK

  Not OK

  N/A

• Tree Saws

  OK

  Not OK

  N/A

• Chain Saws (Note: Check Chain Catch)

  OK

  Not OK

  N/A

• Tree Trimmer Box

  OK

  Not OK

  N/A

• Hydraulic Trimmer

  OK

  Not OK

  N/A

• Hot Stick Box

  OK

  Not OK

  N/A

• Hot Stick

  OK

  Not OK

  N/A

• Fuse Stick

  OK

  Not OK

  N/A

• Extendo FG Stick

  OK

  Not OK

  N/A

• Link Sticks

  OK

  Not OK

  N/A

• Line Hose

  OK

  Not OK

  N/A

• Blanket

  OK

  Not OK

  N/A

• Live Line Tools

  OK

  Not OK

  N/A

• Hard Cover

  OK

  Not OK

  N/A

• Hoods

  OK

  Not OK

  N/A

• Brace and Bit

  OK

  Not OK

  N/A

• Volt Meter

  OK

  Not OK

  N/A

• Please inspect each item indicating if the condition of the item is OK, Not OK, or Not Applicable.

• Are you conducting this inspection on a vehicle?

  Yes

  No

First Aid Kit

• First Aid Kit (NOTE: Remove expired over the counter drugs)

  OK

  Not OK

  N/A

• First Aid Kit Decal

  OK

  Not OK

  N/A

Bloodborne Pathogen Kit

• Bloodborne Pathogen Kit Decal

  OK

  Not OK

  N/A

• One-Way CPR Mask

  OK

  Not OK

  N/A

• Gloves

  OK

  Not OK

  N/A

• Eye Protection

  OK

  Not OK

  N/A

AED

• AED Available

  Yes

  No

• AED Batteries Good

  OK

  Not OK

  N/A

• AED Decal

  OK

  Not OK

  N/A

Fire Extinquisher

• Fire Extinguisher Decal

  OK

  Not OK

  N/A

• greater than 10k GVWR minimum 2 B:C 10 lbs extinquishers

  OK

  Not OK

  N/A

• less than 10k GVWR minimum 1 B:C 10 lbs extinquisher

  OK

  Not OK

  N/A

• Inspection Tags Present

  OK

  Not OK

  N/A

• Date Inspection Completed (indicated on tag)

  Date

• Full Charge

  OK

  Not OK

  N/A

• Pin to Lock the Handle

  OK

  Not OK

  N/A

• Seal to Secure the Pin

  OK

  Not OK

  N/A

• Remarks or Notes

• Please inspect each item indicating if the condition of the item is OK, Not OK, or Not Applicable.

• Are you conducting this inspection on a trailer?

  Yes

  No

• DOT Annual Inspection Card Present

  Yes

  No

  N/A

• Lights

  OK

  Not OK

  N/A

• Reflectors

  OK

  Not OK

  N/A

• Hitch and Tongue

  OK

  Not OK

  N/A

• Tires/Wheels/Rims

  OK

  Not OK

  N/A

• Brakes

  OK

  Not OK

  N/A

• Axle

  OK

  Not OK

  N/A

• Springs, Shackles, & U-Bolts

  OK

  Not OK

  N/A

• Safety Chains

  OK

  Not OK

  N/A

• Braces and Frame (Check for Weld Cracks and Bending)

  OK

  Not OK

  N/A

• Stanchions & Binders

  OK

  Not OK

  N/A

• Safety Pins, Clips, & Hasps

  OK

  Not OK

  N/A

• Break Away Switch

  OK

  Not OK

  N/A

• Battery & Battery Box

  OK

  Not OK

  N/A

• Power Cable & Cable Receptacle

  OK

  Not OK

  N/A

• Hydraulic Leaks

  OK

  Not OK

  N/A

• Hydraulic Controls

  OK

  Not OK

  N/A

• Remarks or Notes.

• Signature

  Sign