Prairie Energy - Driver's Daily Vehicle Inspection Report

• Driver's Vehicle Inspection Report

• Inspected on

  Date

• Inspected By

• Description

• VEHICLE GVWR

• VEHICLE MODEL

• VEHICLE NUMBER

• Either place a check mark in the appropriate block for any item found to be defective or check "No Defects Found" if you feel the vehicle is safe to operate.

• ENGINE

• TRANSMISSION/CLUTCH

• STEERING MECHANISM

• HORN

• WINDSHIELD WIPERS

• REAR VISION MIRRORS

• LIGHTING DEVICES/REFLECTORS

• PARKING BRAKE

• SERVICE BRAKES

• TIRES

• WHEELS AND RIMS

• EMERGENCY EQUIPMENT

• TRAILER COUPLING DEVICE

• TRAILER LIGHTS

• TRAILER TIRES/BRAKES

• TRUCK/TRAILER MUD FLAPS

• OTHER

• DESCRIPTION OF "OTHER"

• NO DEFECTS FOUND

• INSPECTED BY - DRIVERS SIGNATURE

  Sign

DEFECT IDENTIFIED ABOVE - INFORMATION

• REMARKS

• PHOTO OF DEFECT IF APPLICABLE

  Media

• ABOVE DEFECT CORRECTED BY

• DATE DEFECT WAS REPAIRED

  Date

• DEFECT CORRECTED BY - SIGNATURE

  Sign

• Note: Previous day's report must be reviewed by and be in the possession of the driver