Nexterra Daily Pre and Post Trip

• Conducted on

  Date

• Prepared by

• Location
  Address

General Information

• Operator Name

• Vehicle Number

• Time

  Date

• Pre or Post Trip?

  PreTrip

  Post Trip

• Odometer Reading

• Saftey Inspection experation (Month and Year)

Vehicle Checklist

• Any visible leaking fluids? If yes, detail type and amount in notes section.

  Yes

  No

• Description

• Tires fully inflated?

  Yes

  No

• Description

• Tire tread adequate?

  Yes

  No

• Description

• Coolant level adequate?

  Yes

  No

• Description

• Truck engine oil level adequate?

  Yes

  No

• Description

• Running lights in working order?

  Yes

  No

• Description

• Brake lights in working order?

  Yes

  No

• Description

• Left and right turn signals working?

  Yes

  No

• Description

• Reverse lights working?

  Yes

  No

• Description

• Rear-view camera working?

  Yes

  No

  N/A

• Description

• Headlights in working order (high and low beam)?

  Yes

  No

• Description

• Horn working?

  Yes

  No

• Description

• Side rear-view mirrors in good condition and adjusted?

  Yes

  No

• Description

• All gauges working?

  Yes

  No

• Description

• All gauge readings within acceptable limits?

  Yes

  No

• Description

• Windshield wipers in working order?

  Yes

  No

• Description

• Fire extinguisher charged?

  Yes

  No

• Description

• Emergency reflectors available?

  Yes

  No

• Description

• Seatbelts in working order?

  Yes

  No

• Description

• All vehicle accident paperwork in glovebox?

  Yes

  No

• Description

• Other Notes:

• Insurance Card, Registration, Medical Card

  Yes

  No

• What is Missing

  Yes

  No

  N/A

External Damage

• Is there any external damage to the vehicle?

  Yes

  No

• Photo of Damage

  Media

• Description of damage

Acknowledgement

• My signature below indicates that I acknowledge that the the information in this checklist is correct and accurate, to the best of my knowledge, at the time of inspection.

• Add signature

  Sign