Information

  • Client / Site / Location

  • Scope of Work

  • Truck Number

  • Conducted on

  • Prepared by

  • Document No.

1.0 - Driver

  • 1.1 - Federal Motor Carrier Pre-Trip Inspection completed?

  • 1.2 - Operator's Daily Log Book is current?

  • 1.3 - Job Ticket has been signed by customer?

  • 1.4 - Current registration card is in the driver's cab?<br>

  • 1.5 - Current insurance card is in the cab?

  • 1.6 - Current Interstate Federal Tax (IFTA) sticker?

  • 1.7 - Current Federal Motor Carrier sticker?

  • 1.8 - Operator has a valid CDL and medical card on his person?

  • 1.9 - Road Permit (if required) is in the cab?

2.0 - Operation

  • 2.1- Three red, reflective triangles are properly secured and easily accessible in truck?

  • 2.2 - All exterior lights on truck and trailer are working and visible?

  • 2.3 - A functioning ABC fire extinguisher is properly secured and easily accessible in the cab?

  • 2.4 - The truck has a stocked first-aid kit?

  • 2.5 - Truck mirrors are not broken and properly secured to truck?

  • 2.6 - Truck windows are intact, free of damage, and all latches are in place?<br>

  • 2.7- The truck has operable windshield wipers, defrosting, and defogging equipment?

  • 2.8 - All tools and maintenance parts are stored in tool boxes and not loose in or around the cab?

  • 2.9 - Personal items do not interfere with the access to or operation of the truck, within the cab space?

  • 2.10 - The reverse alarm is working and effective?

  • 2.11 - The truck air horn and/or electric horn are in working order?

  • 2.12 - Truck mud flaps are not damaged and are securely mounted?

  • 2.13 - All spreader bars are clearly marked with their ID#, capacity chart, current inspection, and are free of visible damage?

  • 2.14 - All chokers are in good condition with legible manufacturer tags or labels?

  • 2.15 - Personnel basket is clean and free of debris?

  • 2.16 - Basket has a legible copy of the approved hand-signals posted in the basket?

  • 2.17 - Basket has dedicated rigging approved for lifting personnel, and it is in good shape with tags and safety shackles?

  • 2.18 - Basket has proper labels and current inspection sticker?

  • 2.19 - Basket has a proper test weight?

3.0 - Observation

  • 3.1 - Air brake is engaged?

  • 3.2 - The parking area is firm, free of obstructions, and the truck is secure?

  • 3.3 - Fuel tanks contain shipping document, NFPA diamond, Flammable label, and Diesel label?

  • 3.4 - All truck personnel are wearing high-visibility clothing and proper PPE? (Safety vest or high-viz shirt, safety toed boots, leather work gloves, safety glasses, and hard hat)

  • 3.5 - Trailer is clean and organized?

  • 3.6 - Cleanliness of truck's exterior is satisfactory?

  • 3.7 - Cleanliness of truck's interior is satisfactory?

  • 3.8 - Driver is free from distractions and working with a focus on the job?

  • 3.9 - Load is properly secured with appropriate chains, binders, straps, or hardware that meet or exceed the necessary load requirements?

4.0 - Customer Input

  • 4.1 - Was the driver on time?

  • 4.2 - Has our driver been polite and courteous?

Customer Comments

Inspector comments

Signatures

  • Operator Signature

  • Inspector Signature

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