Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Date and Time audit began

VEHICLE DESCRIPTION

  • Photograph of Vehicle Being Inspected

  • LKC Vehicle Unit Number (Drivers Alert Sticker on Rear of Unit)

  • Year

  • Type

  • Make

  • Model

  • VIN (Vehicle Inspection Number)

  • License Number

  • License State

  • USDOT Identification Number

  • Odometer Reading at Inspection

EXTERIOR LIGHTING

  • High and Low Beams Operational

  • Clearance, Marker Lights Operational

  • Left and Right Tail Lights Operational

  • Left and Right Front Turn Signals Operational

  • Left and Right Rear Turn Signals Operational

  • Left and Right Break Lights Operational

  • Left and Right Back-Up Lights Operational

  • License Plate Light Operational

  • Audible Back-up Alarm Operational

EXTERIOR BODY AND GLASS (Take Photos of any noted damage)

  • Windshield Free of Cracks and Chips

  • Front Hood, Grill and Bumper free of Damage

  • Left Mirrors adjustable and Free of Damage

  • Left Fender Free of Damage

  • Left Door Free of Damage

  • Left Side Free of Damage

  • Left Side Windows Free of Cracks and Chips

  • Rear WIndow Free of Cracks and Chips

  • Rear of Vehicle and Bumper Free of Damage (Tailgate if included)

  • Right Side Free of Damage

  • License Plate / Tag is current and not expired / Note expiration date and verify to registration

  • Right Side Windows Free of Cracks and Chips

  • Right Door Free of Damage

  • Right Front Fender Free of Damage

  • Right Mirror Adjustable and Free of Damage

  • Vehicle is Clean and Free of Road Grime and Dirt

TIRES

  • Front Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Driver (INSIDE) Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  • Rear Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Rear Passenger (INSIDE) Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  • Front Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  • Adequate Spare Tire is Available if Necessary in Good Repair with No Visible Signs of Wear or Cracking in Sidewall

  • Front Driver and Passenger Wheel/Tire Trim Rings in Place

  • Rear Driver and Passenger Wheel/Tire Trim Rings in Place

INTERIOR

  • Driver Seat in Good Repair

  • Driver Seat Belt Operational with Shoulder Harness

  • Windshield Wipers Functioning Appropriately

  • Windshield Washer Fluid Functioning and Appropriately Wetting Windshield to Clean

  • Heater and Defroster Operational

  • Air Conditioning Operational

  • Dashboard Lights Operational

  • All Gauges are Operating and Show within Appropriate Ranges

  • Interior Compartment Lights Operational

  • Interior is Clean and Free of Loose Objects

  • Passenger Seat Belts Operational

  • Passenger Seats in Good Repair

SAFETY EQUIPMENT

  • Vehicle is Equipped with Two Way Radio System or Driver Has Cell Phone when Vehicle is in Operation

  • Securely mounted First Aid Kit (Ensure Completely Stocked)

  • Highway safety triangles available

  • Fire Extinguisher Charged and Inspected Monthly?

  • Onboard Oxygen tanks secured in DOT approved brackets?

REQUIRED DOCUMENTATION

  • Valid Vehicle Registration is located in Vehicle (Note where kept)

  • Valid Vehicle Insurance Certificate is Located in Vehicle (Note where kept)

  • Is Vehicle Serviced According to the Manufacturers Schedule?

  • Date of Last Service (List Details of Last Service, i.e. New Tires, Oil Change, ect...)

  • Are Adequate Preventative Maintenance and Service Repair Records Kept

SIGNATURES

  • Signature of Auditor

  • Signature of Community Representative

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.