Pre trip vehicle inspection - duplicate

• Document No.

• Location

• Conducted on

  Date

• Prepared by

Vehicle informations

• UNIT

• KMS

• TOWING TRAILER ?

• TRAILER PLATE #

Inspection points

• TRAILER HITCH IS CONNECTED/ PINNED / PLUGGED IN / SAFETY CHAINS ATTACHED / JACK RETRACTED

  Yes

  No

  N/A

• CARGO IS SECURED PROPERLY WITH RATED TIE DOWNS

  Yes

  No

  N/A

• BRAKES/ PARKING BREAK

  Safe

  At Risk

  N/A

• TIRE CHALKS

  Yes

  No

  N/A

• TIRES (TREAD/ LUGS)

  Safe

  At Risk

  N/A

• DRIVER CONTROLS

  Safe

  At Risk

  N/A

• SEAT/ SEAT BELT

  Safe

  At Risk

  N/A

• EMERGENCY EQUIPMENT

  Safe

  At Risk

  N/A

• FRAME/ BODY

  Safe

  At Risk

  N/A

• WINDSHIELD/ WIPERS/ MIRRORS

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• LIGHTS/ SIGNALS FUNCTIONING

  Yes

  No

  N/A

• BACK UP BEACON FUNCTIONING

  Yes

  No

  N/A

• STEERING

  Safe

  At Risk

  N/A

• SUSPENSION

  Safe

  At Risk

  N/A

• OIL/ COOLANT LEVELS ARE GOOD

  Yes

  No

  N/A

• AIR PRESSURE

  Safe

  At Risk

  N/A

• NAME

• SIGNATURE

  Sign