PSE Heavy Truck Preventative Maintenance

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date and Time audit began

  Date

VEHICLE DESCRIPTION

• Photograph of Vehicle Being Inspected

  Media

• Check for Drivers Alert Sticker on Rear of Unit

• PSE vehicle ID number

• USDOT Identification Number is visible

• check for current DOT inspection Sticker

  Yes

  No

  N/A

• Odometer reading at Inspection

Vital Vehicle Fluid Levels and Condition

• Change Engine Oil & Filter

  Yes

  No

  N/A

• Transmission Fluid Condition

  Yes

  No

  N/A

• Power Steering Fluid

  Yes

  No

  N/A

• Engine Coolant

  Yes

  No

  N/A

• Brake Fluid

  Yes

  No

  N/A

• Differential Fluid

  Yes

  No

  N/A

• Transfer Case Level

  Yes

  No

  N/A

• Window Washer Fluid

  Yes

  No

  N/A

EXTERIOR LIGHTING

• High and Low Beams Operational

  Yes

  No

  N/A

• Clearance, Marker Lights Operational

  Yes

  No

  N/A

• Left and Right Tail Lights Operational

  Yes

  No

  N/A

• Left and Right Front Turn Signals Operational

  Yes

  No

  N/A

• Left and Right Rear Turn Signals Operational

  Yes

  No

  N/A

• Left and Right Break Lights Operational

  Yes

  No

  N/A

• Left and Right Back-Up Lights Operational

  Yes

  No

  N/A

• License Plate Light Operational

  Yes

  No

  N/A

• Audible Back-up Alarm Operational

  Yes

  No

  N/A

EXTERIOR BODY AND GLASS (Take Photos of any noted damage)

• Add media

  Media

• Windshield Free of Cracks and Chips

  Yes

  No

  N/A

• Front Hood, Grill and Bumper free of Damage

  Yes

  No

  N/A

• Left Mirrors adjustable and Free of Damage

  Yes

  No

  N/A

• Left Fender Free of Damage

  Yes

  No

  N/A

• Left Door Free of Damage

  Yes

  No

  N/A

• Left Side Free of Damage

  Yes

  No

  N/A

• Left Side Windows Free of Cracks and Chips

  Yes

  No

  N/A

• Check fuel tank and straps

  Yes

  No

  N/A

• Rear WIndow Free of Cracks and Chips

  Yes

  No

  N/A

• Rear of Vehicle and Bumper Free of Damage (Tailgate if included)

  Yes

  No

  N/A

• Right Side Free of Damage

  Yes

  No

  N/A

• Right Side Windows Free of Cracks and Chips

  Yes

  No

  N/A

• Right Door Free of Damage

  Yes

  No

  N/A

• Right Front Fender Free of Damage

  Yes

  No

  N/A

• Right Mirror Adjustable and Free of Damage

  Yes

  No

  N/A

• Vehicle is Clean and Free of Road Grime and Dirt

  Yes

  No

  N/A

TIRES

• Front Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Driver (INSIDE) Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  Safe

  At Risk

  N/A

• Rear Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Rear Passenger (INSIDE) Driver Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall (If Dual Tire Vehicle)

  Safe

  At Risk

  N/A

• Front Passenger Tire in Good Repair with no Visible Signs of Wear or Cracking in Sidewall

  Safe

  At Risk

  N/A

• Front Driver and Passenger Wheel/Tire Trim Rings in Place

  Yes

  No

  N/A

• Rear Driver and Passenger Wheel/Tire Trim Rings in Place

  Yes

  No

  N/A

BRAKES

• Check And Adjust All Brakes

  Safe

  At Risk

  N/A

• Front Axle Brakes

  Select 100 percent 75 percent 50 percent 25 percent 10 percent needs brakes immediately

  • 100 percent
  • 75 percent
  • 50 percent
  • 25 percent
  • 10 percent
  • needs brakes immediately

• Rear axle Brakes

  Select 100 percent 75 percent 50 percent 25 percent 10 percent needs brakes immediately

  • 100 percent
  • 75 percent
  • 50 percent
  • 25 percent
  • 10 percent
  • needs brakes immediately

INTERIOR

• Driver Seat air ride suspension & upholstery

  Safe

  At Risk

  N/A

• Driver Seat Belt Operational with Shoulder Harness

  Safe

  At Risk

  N/A

• Windshield Wipers Functioning Appropriately

  Yes

  No

  N/A

• Check low air warning buzzer and light

  Yes

  No

  N/A

• Windshield Washer Fluid Functioning and Appropriately Wetting Windshield to Clean

  Yes

  No

  N/A

• Heater and Defroster Operational

  Yes

  No

  N/A

• Air Conditioning Operational

  Yes

  No

  N/A

• Dashboard Lights Operational

  Yes

  No

  N/A

• All Gauges are Operating and Show within Appropriate Ranges

  Yes

  No

  N/A

• Check Bin Heaters for proper operation

  Yes

  No

  N/A

• Check horns, electric & air

  Yes

  No

  N/A

• Interior Compartment Lights Operational

  Yes

  No

  N/A

• Check batteries- visual inspection of cables and connectors, fill fluid level as necessary

  Yes

  No

  N/A

• Under Storage Lights Operational

  Yes

  No

  N/A

• Entry Grab Bar/Rail Secure

  Safe

  At Risk

  N/A

• Interior is Clean and Free of Loose Objects

  Yes

  No

  N/A

• Passenger Seat Belts Operational

  Safe

  At Risk

  N/A

• Check A/C & Heating in Cab

  Yes

  No

  N/A

• Passenger Seats in Good Repair

  Safe

  At Risk

  N/A

Under Carriage Inspection

• Check Driveline & U Joints

  Safe

  At Risk

  N/A

• Check Ball Joints

  Yes

  No

  N/A

• Check Exhaust System and Hardware

  Yes

  No

  N/A

• Check springs, hangers, shocks

  Yes

  No

  N/A

• Grease Complete Chassis

  Yes

  No

  N/A

SAFETY EQUIPMENT

• Securely mounted First Aid kit

  Safe

  At Risk

  N/A

• Highway safety triangles available

  Yes

  No

  N/A

• Fire Extinguisher

  Safe

  At Risk

  N/A

REQUIRED DOCUMENTATION

• Valid Vehicle Registration is located in Vehicle (Note where kept)

  Yes

  No

  N/A

• Valid Vehicle Insurance Certificate is Located in Vehicle (Note where kept)

  Yes

  No

  N/A

SIGNATURES

• Comments?

  Yes

  No

  N/A

• Repairs Completed?

  Yes

  No

  N/A

• All repairs not completed (please list)

  Yes

  No

  N/A

• Signature of Mechanic Performing Service

  Sign