Kelleher Construction DOT Check List

• Company & Location
  Address

• Conducted on

  Date

• Prepared by

  Dave Brennhofer

  James Hockensmith

  Troy Schesso

  Moises Vidal Hernandez

• Truck Number:

  Dave

  James

  Truck 1

  Truck 2

  Shop Truck

• Vehicle Photo (optional For Damage)

  Media

• Vehicle Type

  Select 3/4 Ton Pickup Dave 3/4 Ton Pickup James Truck 1 Truck 2 Shop Truck

  • 3/4 Ton Pickup Dave
  • 3/4 Ton Pickup James
  • Truck 1
  • Truck 2
  • Shop Truck

• Registration current?

  Yes

  No

• Insurance current?

  Yes

  No

• Annual inspection current?

  Yes

  No

• Post-trip inspections accurate and complete?

  Yes

  No

• Odometer:

• Tires in good condition?

  Yes

  No

• Mud flaps in place?

  Yes

  No

• Head lamps

  Yes

  No

• High Beams

  Yes

  No

• Front turn signals

  Yes

  No

• Identification (cab) lights

  Yes

  No

  N/A

• Side marker lamps

  Yes

  No

  N/A

• Tail lamps

  Yes

  No

• Brake lamps

  Yes

  No

• Warning (4-way) lamps

  Yes

  No

• Reverse (back-up) lamps / Alarm

  Yes

  No

• License plate lamp

  Yes

  No

• Trailer info if applicable

Trailer info

• Trailer Type:

  T 50-1

  T50-2

  PJ1

• Registration current?

  Yes

  No

  N/A

• Annual inspection current?

  Yes

  No

  N/A

• Tires in good condition?

  Yes

  No

  N/A

• Mud flaps in place?

  Yes

  No

  N/A

• Tail lamps

  Yes

  No

  N/A

• Brake lamps

  Yes

  No

  N/A

• Hazard (warning) lamps

  Yes

  No

  N/A

• License plate lamp

  Yes

  No

  N/A

• Side marker lamps

  Yes

  No

  N/A

• Truck bed/trailer free of loose equipment, tools, and cargo?

  Yes

  No

  N/A

• Tie-downs and straps in good condition?

  Yes

  No

  N/A

• Load is secure

  Yes

  No

  N/A

• Fire extinguisher mounted and in service?

  Yes

  No

  N/A

• Accident/breakdown warning triangles available?

  Yes

  No

• Is there spare fuses?

  Yes

  No

• Is there a first aid kit?

  Yes

  No

• Driver Name:

  Dave Brennhofer

  James Hockensmith

  Troy Schesso

  Moises Vidal Hernandez

• License current?

  Yes

  No

• License class (select all that apply):

  Select Class A Class B Class C Class D Restricted CDL Temporary CDL

  • Class A
  • Class B
  • Class C
  • Class D
  • Restricted CDL
  • Temporary CDL

• undefined

• License adequate for vehicle type?

  Yes

  No

• Endorsements adequate for vehicle type?

  Yes

  No

• Medical card current?

  Yes

  No

We have discussed any defects and/or corrections needed

• Driver signature

  Sign