Title Page
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Conducted on
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Prepared by
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Location
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Job Number:
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Truck License Plate or Description:
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Trailer License/ Description:
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Odometer Reading:
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1. Licence Plate (current)
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2. Registration In Vehicle
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3. Safety Inspection Stickers
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4. Coupling Devices
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5. Fire Extinguisher
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6. Emergency Equipment & Safety Devices
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(4-way flashers, First Aid and safety triangles)
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7. Seats & Seat Belts
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8. Electric Brake System for Trailer (checked)
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9. Hydraulic Brake System/Fluid Level
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10. Parking Brake/Trailer Break-Away Brake
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11. Exterior Body & Frame
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12. General Defects
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13. Exhaust System
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14. Oil Level
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15. Coolant Level
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16. Windshield Wiper/Washer Fluid level
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17. Power Steering & Fluid Level
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18. Horn
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19. Glass and Mirrors
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20. Lamps and Reflectors- (high and low beam, tail, signal and brake lights)
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21. Heater/Defroster
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22. Suspension System
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23. Tire Pressure- Truck and Trailer (check door post for recommended pressure)
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24. Wheels, Hubs & Fasteners
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25. Cargo Securement
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26. Driver Controls-accelerator, gauges, audible or visual warning devices
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Defects found?
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Description of Defect:
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Date Repaired
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The above noted defects were repaired
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I declare that the vehicle(s) shown above has (have) been inspected in accordance with the applicable requirements.
