Information
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Employee Name - Vehicle Inspection - Vehicle # (Please write it as you see here).
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Document No.
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Vehicle Owner:
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Conducted on
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Prepared by:
- James Shifflett
- Chuck Ayers
- Joseph Bailey
- Michael Dwyer
- Christopher Cole
- James Brown
- Lee Ratliff
- Michael Wright
- Mark A. Davis
- Mark D. Davis
- Richard Dickinson
- Hugh French
- Jason Corbin
- Anthony Beverly
- Scott Taylor
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Location
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Select date
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Take a picture of the vehicle on all four sides.
VEHICLE DESCRIPTION
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Driver Name:
- James Shifflett
- Chuck Ayers
- Joseph Bailey
- Michael Dwyer
- Christopher Cole
- James Brown
- Lee Ratliff
- Michael Wright
- Mark A. Davis
- Mark D. Davis
- Richard Dickinson
- Hugh French
- Jason Corbin
- Anthony Beverly
- Scott Taylor
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Make of vehicle:
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Photo of vehicle identification number:
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Odometer reading:
EXTERIOR LIGHTING
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The high and low beams are operational.
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The left and right tail lights are operational.
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The left and right front turn signals are operational.
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The left and right rear turn signals are operational.
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The left and right break lights are operational.
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The left and right back-up lights are operational.
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The front and back license plate lights are operational.
EXTERIOR BODY AND GLASS
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The windshield is free of cracks and chips larger than a 10c piece.
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The front hood, grill and bumper are free of damage.
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The left mirrors are adjustable and free of damage.
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The left fender is free of damage.
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The left door is free of damage.
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The left side is free of damage.
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The left side windows are free of cracks and chips.
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The rear window is free of cracks and chips.
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The rear of the vehicle and bumper are free of damage.
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The right side is free of damage.
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The license plate(s) are in place and tags are current and not expired (note the expiration date).
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The right side windows are free of cracks and chips.
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The right door is free of damage.
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The right front fender is free of damage.
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The right mirror is adjustable and free of damage.
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The vehicle is clean and free of road grime and dirt.
TIRES
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The front driver tire is in a good condition with no visible signs of damage.
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The rear driver tire is in a good condition with no visible signs of damage.
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The rear passenger tire is in a good condition with no visible signs of damage.
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The front passenger tire is in a good condition with no visible signs of damage.
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The spare tire is in a good condition with no visible signs of damage.
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All the wheels and rims are free of damage.
INTERIOR
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Take a photo of the interior of the vehicle from both the drivers side and passenger side.
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The driver seat belt is in a good condition.
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The windshield wipers are functioning and in a good condition.
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The windshield washer fluid level is acceptable and the washer is operational.
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The heater and defroster are operational.
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The air conditioning is operational.
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The dashboard lights are operational.
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All the gages are operational and show within the acceptable ranges.
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The interior compartment lights are operational.
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The interior is clean and free of loose objects.
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The passenger seat belts are operational.
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The passenger seats are in a good and clean condition.
REQUIRED DOCUMENTATION
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The vehicle is serviced according to the manufacturers schedule.
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Note the date of the last service:
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Note the odometer reading at the last service:
SIGNATURES
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Signature of driver / responsible person:
SUMMARY
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All damages noted in this report reported within (24) hours of occurrence or discovery?
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Service has been scheduled if necessary?
