LEG Commercial Motor Vehicle

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Tractor Cab Exterior

• Windshield - Front / Rear

  Good

  Repair

  Replace

  N/A

• Wipers - Front

  Good

  Repair

  Replace

  N/A

• Clearance Lights / Hood

  Good

  Repair

  Replace

  N/A

• Mirrors - Side / Hood

  Good

  Repair

  Replace

  N/A

• Turn Signals, Front, Side Rear

  Good

  Repair

  Replace

  N/A

• Headlights - Front

  Good

  Repair

  Replace

  N/A

• Hood Latches - Side

  Good

  Repair

  Replace

  N/A

• Tires / Rims - All

  Good

  Repair

  Replace

  N/A

• Plate / Dot Tag - Font / Rear

  Good

  Repair

  Replace

  N/A

• Air lines at Base and Seals

  Good

  Repair

  Replace

  N/A

• Pig tail at Both Ends

  Good

  Repair

  Replace

  N/A

• Headache Rack

  Good

  Repair

  Replace

  N/A

• Winch / Winch Line

  Good

  Repair

  Replace

  N/A

• Snatch Blocks / Wire Rope

  Good

  Repair

  Replace

  N/A

• Chains, Straps, Slings, Hooks

  Good

  Repair

  Replace

  N/A

• Boomers - Ratchet / Pull Down

  Good

  Repair

  Replace

  N/A

• Tractor Cab Exterior

  Clean

  Dirty

  N/A

• Tractor Cab Exterior Not a driving hazard

  Yes

  No

  N/A

• Drive Shaft<br>

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

Cab Interior

• Panel Lights

  Good

  Repair

  Replace

  N/A

• All Gauges Working

  Good

  Repair

  Replace

  N/A

• Air Pressure Holding at 120 PSI

  Good

  Repair

  Replace

  N/A

• Low Air Indicator - light buzzer

  Good

  Repair

  Replace

  N/A

• Seat Belt Working

  Good

  Repair

  Replace

  N/A

• Defroster Working

  Good

  Repair

  Replace

  N/A

• Cab Interior

  Clean

  Dirty

  N/A

• Cab Interior Not a Driving Hazard

  Yes

  No

  N/A

• Comments:

• Add media

  Media

Vehicle Documents

• Registration

  Good

  Repair

  Replace

  N/A

• Insurance Cab Card

  Good

  Repair

  Replace

  N/A

• Insurance Card

  Good

  Repair

  Replace

  N/A

• Inspection book (DVIR)

  Good

  Repair

  Replace

  N/A

• Wire Rope Certificates

  Good

  Repair

  Replace

  N/A

• Accident Report Envelope

  Good

  Repair

  Replace

  N/A

• Permits Oversize / Weight

  Good

  Repair

  Replace

  N/A

• Vacuum must WHP at all times

  Good

  Repair

  Replace

  N/A

• Bill of Lading

  Good

  Repair

  Replace

  N/A

• Shipping papers

  Yes

  No

  N/A

• SDS Available (if applicable)

  Yes

  No

  N/A

• HAZMAT Guidebook

  Good

  Repair

  Replace

  N/A

• Emergency Response Guidebook

  Good

  Repair

  Replace

  N/A

• Vehicle Documents complete

  Yes

  No

  N/A

• Vehicle Documents Not a Driving Hazard

  Yes

  No

  N/A

• Comments:

• Add media

  Media

Driver Documents

• CDL

  Good

  Repair

  Replace

  N/A

• Medical Card (Exp. Date)

  Good

  Repair

  Replace

  N/A

• Logbook (Current)

  Good

  Repair

  Replace

  N/A

• Driver documents

  Yes

  No

  N/A

• Vehicle Documents Not a Driving Hazard

  Yes

  No

  N/A

• Comments:

• Add media

  Media

Emergency Equipment

• Fire Extinguisher (mounted)

  Good

  Repair

  Replace

  N/A

• Reflective Tri - Angels

  Good

  Repair

  Replace

  N/A

• First Aid Kit/BBP Kit

  Good

  Repair

  Replace

  N/A

• Emergency Equipment

  Clean

  Dirty

  N/A

• Emergency Equipment Not a Driving Hazard

  Yes

  No

  N/A

• Comments

• Add media

  Media

Under the Hood

• Fluids - Coolant, Power Steering, oil, wash fluid.

  Good

  Repair

  Replace

  N/A

• Air Filter - Gauge Glass

  Good

  Repair

  Replace

  N/A

• Belts, hoses, (water, air)

  Good

  Repair

  Replace

  N/A

• Fan / Housing

  Good

  Repair

  Replace

  N/A

• Exhaust Lines

  Good

  Repair

  Replace

  N/A

• Steering Linkage

  Good

  Repair

  Replace

  N/A

• Front Leaf Spring / U Bolts

  Good

  Repair

  Replace

  N/A

• Front Brake Chamber

  Good

  Repair

  Replace

  N/A

• Break Line Hoses

  Good

  Repair

  Replace

  N/A

• Interior of tire, Rim

  Good

  Repair

  Replace

  N/A

• Leaks - Accumulation of Dirt

  Good

  Repair

  Replace

  N/A

• Under the Hood

  Clean

  Dirty

  N/A

• Under the Hood Not a Driving Hazard

  Yes

  No

  N/A

• Comments:

• Add media

  Media

Trailer Inspection

• Air Lines at Base and Seals

  Good

  Repair

  Replace

  N/A

• Pig Tails at Both Ends

  Good

  Repair

  Replace

  N/A

• Fifth Wheel Locked

  Good

  Repair

  Replace

  N/A

• Landing gear up

  Good

  Repair

  Replace

  N/A

• Reflective Tape on Frame, Truck Tractor, Back of Cab, and across Mud flap Brackets

  Good

  Repair

  Replace

  N/A

• Frame Integrity - No Cracks

  Good

  Repair

  Replace

  N/A

• Air Bags - Inflated Fully

  Good

  Repair

  Replace

  N/A

• Leaf Springs/ U bolts

  Good

  Repair

  Replace

  N/A

• Tires and Rims - All

  Good

  Repair

  Replace

  N/A

• Shocks

  Good

  Repair

  Replace

  N/A

• Brake Chambers - No Air Leaks

  Good

  Repair

  Replace

  N/A

• Hub Grease Sight Glass

  Good

  Repair

  Replace

  N/A

• Lugnuts - All there

  Good

  Repair

  Replace

  N/A

• Clearance Lights- All

  Good

  Repair

  Replace

  N/A

• Turn Signals - Side, Rear

  Good

  Repair

  Replace

  N/A

• Break Lights W/ turn Signals On

  Good

  Repair

  Replace

  N/A

• License Plate - Light On

  Good

  Repair

  Replace

  N/A

• Trailer Floor - Swept Clean

  Good

  Repair

  Replace

  N/A

• Winch / Winch Line

  Good

  Repair

  Replace

  N/A

• Snatch Blocks / Wire Rope

  Good

  Repair

  Replace

  N/A

• Chains, Straps, Slings, Hooks

  Good

  Repair

  Replace

  N/A

• Roller Bar

  Good

  Repair

  Replace

  N/A

• Bushings

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

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• Any additional information

• Inspected By / HSE TECH:

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• On Site Representative

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