Information
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Company & Location
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Conducted on
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Prepared by
Vehicle Information
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Unit Number:
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Vehicle Photo (optional)
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Vehicle Type
- Semi
- LP Bobtail
- Liquid Fuel Truck
- Pick-up
- Flatbed
- Tender truck - Liquid
- Tender truck - Dry
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Registration current?
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Insurance current?
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Annual inspection current?
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Post-trip inspections accurate and complete?
Vehicle Condition
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Odometer:
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Is cab of vehicle clean and organized?
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Tires in good condition?
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Mud flaps in place?
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Required lamps operative?
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Head lamps
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Brights
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Front turn signals
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Identification (cab) lights
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Side marker lamps
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Tail lamps
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Brake lamps
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Warning (4-way) lamps
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Reverse (back-up) lamps
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License plate lamp
Trailer Information
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Unit Number:
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Trailer Type:
- Flatbed
- Van/Box
- Liquid/Chemical
- Dry Fertilizer
- Dump
- Petroleum
- NH3 Nurse Tank
- LPG/NH3 Transport
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Registration current?
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Annual inspection current?
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Tires in good condition?
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Mud flaps in place?
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Required lights operative?
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Tail lamps
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Brake lamps
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Hazard (warning) lamps
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Backup (reverse) lamps
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License plate lamp
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Side marker lamps
Load Securement
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Truck bed/trailer free of loose equipment, tools, and cargo?
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Tie-downs and straps in good condition?
Hazardous Materials
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Shipping documents in cab?
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Shipping documents accurate and complete?
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Hazardous Materials registration in cab?
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Placarding in good condition, on all 4 sides, and correct for material?
Emergency Equipment
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Fire extinguisher mounted and in service?
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Accident/breakdown warning triangles available?
Driver Information
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Driver Name:
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License current?
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License class (select all that apply):
- Class A
- Class B
- Class C
- Class D
- Restricted CDL
- Temporary CDL
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License adequate for vehicle type?
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Endorsements (select all that apply):
- T = Double/Triple
- P = Passenger
- N = Tank
- H = Hazardous Materials
- S = School Bus
- X = Combination Tank/Hazardous Materials
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Endorsements adequate for vehicle type?
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Restrictions (select all that apply):
- L = Air Brakes
- Corrective Lenses
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Restrictions adequate for vehicle type?
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Medical card current?
