Title Page

Basic Information

  • Today's Date

  • Kemah tx

  • Driver Name David Laboy

  • 00258784

  • Mario Gariby

  • 5116

  • 164000

Tires

  • Current Tire Condition

  • Spare Tire

Under Hood Inspection

  • Brake Fluid Level

  • Windshield Washer Fluid

  • Hoses

  • Remove Debris From Radiator Core

  • Coolant Level

  • Power Steering Fluid

  • Transmission Fluid

  • Belts

  • Engine Oil

  • Oil Change Mileage and Date

Lights

  • Headlights

  • High Beam

  • Low Beam

  • Hazard Lights

  • Instrument Lights

  • Brake Lights

  • Tail Lights

  • Beacon

  • Turn Signals

  • Check Engine Light

  • Oil Pressure

  • Emergency Brake Light

  • Engine Temperature

Safety Features

  • Windshield Wipers

  • Windshield/Windows

  • Seat Belts

  • Mirrors

  • Horn

  • Back Up Alarm

  • First Aid Kit

  • Cones

  • Fire Extinguisher

  • Foreign Voltage Detector

  • AR Sticker

Aerial Lift Vehicle

  • ONAN Oil Level

  • Hydraulic Fluid Level

  • Hydraulic Leaks Exterior/Interior

  • Upper Boom Control Operational

  • Lower Boom Control Operational

  • Boom Inspection Date

Documentation

  • Vehicle Registration and Inspection Sticker (Attach Photo)

  • Accident Reporting Form

  • Insurance Card

  • Vehicle Registration Form

Personal Protective Equipment

  • Hard Hat

  • Safety Glasses

  • Hand Protection

  • Foot Protection

  • Climbing Belt

Comments

  • Driver Comments

  • Driver Signature

  • Supervisor Signature

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