Manager Vehicle Inspection

• Department Number

• Truck Number

• Current Vehicle Mileage

• Conducted on

  Date
• Location
  Address

• Current Driver

• Completed by:

Fluid Levels - Check all that are in full / acceptable range.

• Oil Level

• Coolant Level

• Washer Fluid

• Brake Fluid

• Steering fluid

• DEF Fluid (if applicable)

• Add detailed notes for any fluids that are not in the safe or acceptable range. Also note any visible leaking or dripping fluids.

Vehicle Exterior (Add additional notes and photos as needed)

• ADD ONE PHOTO OF EACH SIDE OF THE VEHICLE. (4) PHOTOS IN TOTAL.

  Media

• Is the exterior of the vehicle clean? (If not add notes and photos)

  Yes

  No

  N/A

• Is there damage to the exterior of the vehicle? (If yes add notes and photos)

  Yes

  No

  N/A

• Windshield - If visible chips or cracks are present, check no and add notes and photos.

  Yes

  No

  N/A

• Are all Decals, Logos, Truck and DOT numbers in good condition?

  Yes

  No

  N/A

Vehicle Interior (Add additional notes and photos as needed)

• ADD ONE PHOTO OF PASSENGER SIDE AND ONE OF THE DRIVER SIDE OF THE VEHICLE. (2) PHOTOS IN TOTAL .

  Media

• Is the vehicle interior clean and tidy? (If not add notes and photos)

  Yes

  No

  N/A

• Is the interior of the vehicle free of damage? (If not, identified damaged areas in notes and add photos)

  Yes

  No

  N/A

Tire Conditions (Add notes and photos if at risk)

• Driver side - Front

  Safe

  At Risk

  N/A

• Passenger side - Front

  Safe

  At Risk

  N/A

• Driver side - Inside rear (if applicable)

  Safe

  At Risk

  N/A

• Driver side - Rear

  Safe

  At Risk

  N/A

• Passenger side - Inside rear (if applicable)

  Safe

  At Risk

  N/A

• Passenger side - Rear

  Safe

  At Risk

  N/A

• Spare tire - (does the vehicle have one?) If so what is it in good condition?

  Safe

  At Risk

  N/A

Check all of the following that are in safe and working condition

• Head lights

• Tail lights

• All signal Indicators

• Service Brakes

• Rear-view mirror

• Side mirrors

• Windshield Wipers

• Steering mechanisms

• Audible back up indicator

• Horn

• Parking (Hand) Brake

• Mud Flaps

• Coupling Device (if applicable)

• Trailer Chains w/ clasps & pins (if applicable)

• Battery and cables

• Add detailed notes for any items that are not in safe or working condition

Safety Accessories - Is the the vehicle equipped with the following?

• Jack

• Safety Triangles

• First Aid kit

• Flares

• Spare Fuses

• Is there a fire extinguisher mounted with a current tag visible?

  Yes

  No

  N/A

Other

• Details of any additional vehicle issues that need to be addressed.

POLE TRUCKS - Check all items that are on the truck or with the driver and in safe and working condition.

• Truck cones

• Tie down straps

• Tire Chalks

• Pulley System

• Arc Flash Equipment

• Safety Vest

• Hard Hat

• Safety Glasses

• Work Gloves

• Work Boots

• Positioning Device

• D-Ring Belt

• Equipment with Light Bar

• Ladder Strap

• Is the Ladder free of defects? (If no add notes and photos)

  Yes

  No

  N/A

• Is the PTO in working condition? Oil Level is acceptable and system free of Leaks?

  Yes

  No

  N/A

• Is the auger safety chain safe, free of damage' and at the proper length? (If not add notes and photos)

  Safe

  At Risk

  N/A

Bucket Trucks - Check all that are preset and in safe and working condition.

• Boom Controls

• Boom Hoses

• Bucket

• Chock Blocks

• Harness

• Note any items that are missing or are not in safe and working condition.

Tow Trucks - Check all that are in safe and working condition.

• Chains / wench Chains

• Bed Pivot Pins (Left and Right side)

• PTO systems

• Are the PTO oil level acceptable and free of leaks

  Yes

  No

  N/A

Fuel Trucks - Check all that are present and in safe and working condition.

• Wheel Seals

• Proper Placards

• Fuel Hose Reels

• Oil Hose Reels

• Are all hoses free of cracks and leaks?

  Yes

  No

  N/A

• Equipped with Hazmat and Emergency kit?

  Yes

  No

  N/A

Vehicle Documents

• Is there a copy of the current registration?

  Yes

  No

  N/A

• Is there a copy of the current and valid Insurance Card?

  Yes

  No

  N/A

• Does the Driver have a valid DOT Diver Med Cert?

  Yes

  No

  N/A

• Current Bit Inspection

• Mechanic Repairs

• Weight Inspection Receipts

• Hazardous Materials Certificate of Registration (If applicable)

Additional Documents

• Accident Forms and Procedures

• Ticket Procedures

• Dig Alert Procedure and Responsibility of NON-DIG Alert

• Hazard Material Communication Program

• Spill Containment & Control Procedures

• Injury Illness & Prevention Program (D/S)

• Heat Illness

• FMCSA HOS Rules and Regulations

• Are all MSDS (Material Safety Data Sheet) Documents (1 - 19) included?

  Yes

  No

  N/A

• Signature of Manager performing the inspection.

  Sign