LEG Commercial Motor Vehicle_3.5

• Bussiness Unit/Department:

• Location/Site

• Location
  Address

• Prepared by

• Conducted on

  Date

CMV Lights

• Clearance Lights / Hood

  Good

  Repair

  Replace

  N/A

• Turn Signals, Front, Side Rear

  Good

  Repair

  Replace

  N/A

• Headlights - Front

  Good

  Repair

  Replace

  N/A

• Pig tail at Both Ends

  Good

  Repair

  Replace

  N/A

• Clearance Lights- All

  Yes

  No

  N/A

• Turn Signals-Side, Rear

  Yes

  No

  N/A

• Brake Lights W/ turn signals ON

  Yes

  No

  N/A

• License Plate-Light ON

  Yes

  No

  N/A

• Comments:

• Add media

  Media

CMV Tires and Rims

• Tires - Steering (4/32)/ Others (2/32)

  Good

  Repair

  Replace

  N/A

• Tires and Rims in good condition (exterior and interior)-All

  Yes

  No

  N/A

• Hub Grease Sight Glass

  Good

  Repair

  Replace

  N/A

• Lug nuts- Complete set (not loose or missing)

  Yes

  No

  N/A

• Comments:

• Add media

  Media

Tractor Cab Exterior

• Windshield - Front / Rear

  Good

  Repair

  Replace

  N/A

• Wipers - Front

  Good

  Repair

  Replace

  N/A

• Mirrors - Side / Hood

  Good

  Repair

  Replace

  N/A

• Hood Latches - Side

  Good

  Repair

  Replace

  N/A

• Plate / Dot Tag - Front / Rear

  Good

  Repair

  Replace

  N/A

• Drive Shaft

  Yes

  No

  N/A

• Headache Rack

  Good

  Repair

  Replace

  N/A

• Chains, Straps, Slings, Hooks (secured)

  Good

  Repair

  Replace

  N/A

• Boomers - Ratchet / Pull Down (secured)

  Good

  Repair

  Replace

  N/A

• Fuel Tanks properly secured.

  Good

  Repair

  Replace

  N/A

• Tractor Cab Exterior Condition

  Clean

  Dirty

  N/A

• Comments:

• Add media

  Media

Trailer Inspection

• 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

• Trailer Floor - Swept Clean

  Good

  Repair

  Replace

  N/A

• Chains, Straps, Slings, Hooks (secured)

  Good

  Repair

  Replace

  N/A

• Mud flaps

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

Under the Hood

• Fluids - Coolant, Power Steering, oil, wind shield 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

• Shocks

  Good

  Repair

  Replace

  N/A

• Leaks - Accumulation of Dirt

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

CMV Brakes

• Air lines at Base and Seals

  Good

  Repair

  Replace

  N/A

• ABS brakes- Lights

  Yes

  No

  N/A

• Air Pressure Holding at 120 PSI (Truck running)

  Good

  Repair

  Replace

  N/A

• (Off) Low Air Indicator - light buzzer (60 PSI)

  Good

  Repair

  Replace

  N/A

• (Off) Brakes- Pop off valves - (45 - 25 PSI)

  Good

  Repair

  Replace

  N/A

• Front Brake Chamber

  Good

  Repair

  Replace

  N/A

• Brake Line Hoses

  Good

  Repair

  Replace

  N/A

• Bleed Air Tanks

  Good

  Repair

  Replace

  N/A

• Air Lines at Base and Seals (glad hands and grommets)

  Good

  Repair

  Replace

  N/A

• Brake Chambers - No Air Leaks

  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

• Horns works properly

  Good

  Repair

  Replace

  N/A

• Seat Belt Working

  Good

  Repair

  Replace

  N/A

• Defroster Working

  Good

  Repair

  Replace

  N/A

• Cab Interior (House Keeping)

  Clean

  Dirty

  N/A

• Comments:

• Add media

  Media

Emergency Equipment

• Fire Extinguisher (mounted and operative)

  Good

  Repair

  Replace

  N/A

• Reflective Tri - Angels (3) (secured)

  Good

  Repair

  Replace

  N/A

• First Aid Kit/BBP Kit (secured)

  Good

  Repair

  Replace

  N/A

• Extra fuses and bulbs.

  Yes

  No

  N/A

• Comments

• Add media

  Media

Vehicle Documents

• Bill of Lading /Shipping Papers

  Good

  Repair

  Replace

  N/A

• SDS Available (if applicable)

  Yes

  No

  N/A

• Registration (Cab and Trailer)

  Good

  Repair

  Replace

  N/A

• DOT Inspection Receipt

  Good

  Repair

  Replace

  N/A

• Insurance Card

  Good

  Repair

  Replace

  N/A

• Insurance Cab Card

  Good

  Repair

  Replace

  N/A

• Inspection book (DVIR)

  Good

  Repair

  Replace

  N/A

• Accident Report Envelope

  Good

  Repair

  Replace

  N/A

• WHP (Vacuum must have one at all times)

  Good

  Repair

  Replace

  N/A

• Permits Oversize / Weight

  Good

  Repair

  Replace

  N/A

• HAZMAT Guidebook

  Good

  Repair

  Replace

  N/A

• Emergency Response Guidebook

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

Driver Documents

• CDL/ Endorsements

  Good

  Repair

  Replace

  N/A

• Medical Card (Exp. Date)

  Good

  Repair

  Replace

  N/A

• Logbook (Current) + previous 7 days

  Good

  Repair

  Replace

  N/A

• HAZMAT Endorsement (If applicable)

  Good

  Repair

  Replace

  N/A

• Comments:

• Add media

  Media

Sign Off

• Truck No.:

• Trailer No.:

• Driver's Name:

• Driver's signature:

  Sign

• Safety/DOT Inspector Name:

• PRE-TRIP INSPECTION

  Off

  On

• POST-TRIP INSPECTION

  Off

  On