Title Page

  • Conducted on

  • Prepared by

  • Location

Information/Inspection

  • Company Name

  • Date

  • Time

  • Driver Name

  • Vehicle Number

  • Duration of Evaluation

  • Weather Conditions

  • Road Conditions

  • Traffic Conditions

Equipment Conditions

  • Pre-trip inspection conducted.

  • Post-trip inspection conducted.

  • Drove with lights on.

  • Used restraint system.

  • Preventive maintenance current.

  • Comments:

Driving Habits

  • Adhered to posted speed limits.

  • Drove at proper speed for weather and road conditions.

  • Followed at safe distances.

  • Proper passing procedures.

  • Yielded right-of-way.

  • Obeyed traffic signals and signs.

  • Used proper turning and backing procedures.

  • Checked and adjusted mirrors prior to departure.

  • Used proper parking and dock procedure.

  • Was aware of other vehicles.

  • Courteous driving behaviors exhibited.

  • Used proper preparation for changing road conditions or situations.

  • Comments

  • Completed by:

  • Date:

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.