Title Page

  • Prepared by

  • Tech Number

  • Conducted on

  • Location

  • Van Number

  • Plate Number

  • Vin Number

  • Mileage

Fluid Levels

  • Oil

  • Transmission

  • Coolant

  • Brake

  • Power Steering

  • Wiper Fluid

Physical Condition

  • Body (Note all Physical Damage)

  • Explain damage to van

  • Photo of Body. Only 1 required

  • Windshield (Note Cracks)

  • Explain damage to windshield

  • Photo of windshield

  • Interior (front/cab)

  • Explain why cab is not clean

  • Photo of clean cab

  • Interior (rear/cargo)

  • Explain why cargo is not clean

  • Photo of clean cargo

Safety Items

  • Headlights

  • Blinkers (front and rear)

  • Brake Lights

  • Wiper Blades

  • Fire Extinguisher

  • Ladder Rack

  • Ladder Cables/ Locks

  • Ladders (must lubricate all joints weekly)

  • Seat Belts

  • Side Mirrors and Blink Spot Mirrors

Tire Pressure

  • Measure front tire pressure. It must be within +/- 3Ibs of recommended pressure. DO NOT OVER INFLATE

  • Measure rear tire pressure. It must be within +/- 3Ibs of recommended pressure. DO NOT OVER INFLATE

Tire Tread Depth

  • Front Tires. Measure tread depth from outer, middle, and inner depth to determine wear. (Minimum 3/32 tread remaining)

  • Rear Tires. Measure tread depth from outer, middle, and inner depth to determine wear. (Minimum 3/32 tread remaining)

Documentation

  • Current Registration

  • Insurance Card

  • Gas Card

Action Required

Explain all "Not Acceptable" and include corrective action and expected completion date

  • Explain issues or N/A

  • I confirm that all this information is correct and valid.

  • Send email to the Office Iauditor and the Warehouse IAs

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.