Documentation in vehicle
Vehicle Registration, Insurance, Do Not Operate Tag
Accident Report Form and Instructions
Interior
Window Operation
Meets Standard
Needs Improvement
not applicable
Door Locks
Meets Standard
Needs Improvement
not applicable
Seatbelts
Meets Standard
Needs Improvement
not applicable
Mirrors properly adjusted
Meets Standard
Needs Improvement
not applicable
No Warning Lights turned on
Roadside Emergency Kit, Triangles, First-Aid Kit
Engine Compartment
Windshield washer fluid
Meets Standard
Needs Improvement
not applicable
Engine oil level
Meets Standard
Needs Improvement
not applicable
Coolant level
Meets Standard
Needs Improvement
not applicable
Brake Fluid level
Meets Standard
Needs Improvement
not applicable
Transmission Fluid Level
Meets Standard
Needs Improvement
not applicable
Exterior
Windows and windshield in good condition
Meets Standard
Needs Improvement
not applicable
Windshield wipers working
Meets Standard
Needs Improvement
not applicable
Headlights functional
Meets Standard
Needs Improvement
not applicable
Tail Lights, Brake Lights & Turn Signals
Meets Standard
Needs Improvement
not applicable
Emergency brake in good condition
Meets Standard
Needs Improvement
not applicable
Power brakes in good condition
Meets Standard
Needs Improvement
not applicable
Tires in good condition
Meets Standard
Needs Improvement
not applicable
Bald tires
Not inflated properly
Damaged tires
Horn working
Meets Standard
Needs Improvement
not applicable
Back-Up Alarm
No grease or oil leaks
Meets Standard
Needs Improvement
not applicable
No fuel leaks
Meets Standard
Needs Improvement
not applicable
Fire Extinguisher in good condition and inspected in the last year?
Additional comments/observation
Observation
Add observations/comments here.
Add media
Media
I hereby certify that all information is accurate, and that after an actual inspection was conducted this vehicle is safe for use.
Auditor's Printed Name & Signature
Sign
link copied
Ryan Lancaster
Highmark Vehicle Safety Inspection Checklist
This Motor Vehicle Safety Inspection Checklist is to be used to determine if a vehicle is safe for use.
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.
