Title Page
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Date of Inspection
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Was this report requested by the current Owner
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Owners Name
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Owners Address
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City
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State/Province
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Zip Code
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Customers Name
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Customers Address
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City
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State/Province
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Zip Code
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Current Owners Name
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Owners Address
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City
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State/Province
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Zip Code
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Same as the Billing Address?
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Billing Address
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City
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State/Province
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Zip Code
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Email
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Where to send the report?
- Main Address
- Billing Address
Unit Information
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Year of Manufacturing
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Manufacturer
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Make
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Model
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Is this a Driveable Unit
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Vin#
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Engine Model
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Location The Inspection was Conducted
Exterior Inspection
Exterior Photos of Unit
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Front
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Curbside (Passenger Side)
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Rear
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Roadside (Drivers Side)
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Under The Unit (Video)
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Roof Top
Wheels and Frame Assemblies
Wheel Assembly
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Number of axles on this unit
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Is this a Drive unit (MotorHome)
Front Steerage Wheel Curbside
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is there a Center Curbside Wheel (Triple axle)
Streetside Steerage Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is there a Center Curbside Wheel (Triple axle)
Forward or SIngle Curbside Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is there a Center Curbside Wheel (Triple axle)
Curbside Center Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is There A Rear Curbside Wheel
Back Curbside Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
Forward or Single Streetside Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is there a Center Curbside Wheel (Triple axle)
Center Curbside Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Is there a Rear Curbside Wheel
Back Streetside Rear Wheel
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Tire Condition
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Tire Tread Condition
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Amount of Tread Remaining
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
Spare Tire
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Is There A Spare TIre On This Unit
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Tire Condition
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Tire Tread Condition
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Tire Brand
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Tire Size
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Is the DOT Date Available?
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DOT Date (Week - Year)
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Load Capacity (Lb) (kg)
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Load Range Grade
- D
- E
- F
- G
- H
- Other
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Explain (Other)
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Maximum Tire Pressure (psi)
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Current Air Pressure in Tire (psi)
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Spare Tire Rack Type
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Spare Tire Rack and Tools
Forward or Single Rear Axle
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Axle Type
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Define (Other)
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Was Rust visible on Axle
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Level of rust visible on axle
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Was there signs of physical damage to axle
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Define damage
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Were there signs of oil stains
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Define Stains
Center Rear Axle
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Is There a Center Axle
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Axle Type
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Define Other Type
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Was Rust visible on Axle
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Level of rust visible on axle
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Was there signs of physical damage to axle
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Define damage
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Were there signs of oil stains
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Define Stains
Back Rear Axle
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Is There a Rear Axle
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Axle Type
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Define Other Type
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Was Rust visible on Axle
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Level of rust visible on axle
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Was there signs of physical damage to axle
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Define damage
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Were there signs of oil stains
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Define Stains
Suspension System
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Condition of U-Bolts and Nuts
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Condition of Leaf Springs
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Condition of Hangers
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Condition of Shackles
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Condition of Spring Equalizer
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Suspension Bolts
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Are Wet bolts present
Condition of Frame
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Was there signs of Physical Damage on the Frame
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Were there signs of Rust
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Level of Rust
Hitch and Stabilizing Systems
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Type of Unit
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Tongue Jack Type
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Condition of Tongue Jack Operation
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Coupler Operational
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Condition of Safety Chains
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Condition of Stabilizers
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Condition of Weight Distribution System
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Condition of Sway Control System
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Type of Landing Gear
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Condition of Front Landing Gear
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Front Landing Gear Operation
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Type of Rear Stabilizing System
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Condition of Rear Stabilizing System
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Rear Stabilizing System Operation
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Visible leaks or Mechanical Issues with Jacks
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Type of Pin Box
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Goose Neck Adaptor
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Is this Unit a Bumper Pull System
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Is there a rear tow system
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Condition of towing receiver
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Type of Power Connection (7 pin or 4 pin)
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Is the cover for the pin connection attached and on the connection
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Did each pin test proper voltage
Chassis 12 Volt DC Systems
Chassis Battery
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Is There a 12-volt Chassis Battery
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12-Volt Chassis Battery - Location
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12-Volt Chassis Battery - Box Condition
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12-Volt Chassis Battery - Cables and Terminal Conditions
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12-Volt Chassis Battery - Vented and Secured
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12-Volt Chassis Battery - Matched for Size and Age
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12-Volt Chassis Battery - Indication of recent Service
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12-Volt Chassis Battery – Type of Batteries
- Lead Acid
- Gel-cell
- AGM(Absorbed Glass Mat)
- Maintenance Free
- Other
- N/A
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Was a specific gravity test conducted
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Was there any cell out of the normal range per battery? (1.20 to 1.265)
Chassis 12-volt DC Lights
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What type of 12v DC power connection to Tow Vehicle is available on this unit
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Condition of the 7-pin Cord (Physical Damage, Corrosion)
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Condition of the 4 pin 12v DC Connector
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Physical Condition of the Breakaway Switch
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Type of Test performed on the Breakaway system
- Each axle raised and both wheels confirmed Braking
- One axle raised and wheel confirmed braking
- No axles raised, amperage test conducted
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What was Amperage Reading
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Are All Front Clearance Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are All Streetside Marker Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are All Rear Clearance Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are All Curbside Marker Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are Left Turn and Left Brake Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are Right Turn and Right Brake Lights Operational
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Are Some Operational Or Are all Non-Operational
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Are All All Backup Lights Operational
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Are Some Operational Or Are all Non-Operational
Life Safety Alarms
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Is Propane and CO Detector together in one unit
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Was Propane Detector Tested
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Propane Detector Test results
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Propane Detector Make
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Model
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Serial Number
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Propane Detector Date
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Propane Detector Test method
- Spraying or releasing LP or Butane
- Pushing Test Button and Spraying LP or Butane
- Not Tested
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Was the CO Detector Tested
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CO Detector Make / Model /Serial Number
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CO Detector Date
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CO Detector Test method
- Spraying or releasing LP or Butane
- Pushing Test Button and Spraying LP or Butane
- Not Tested
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Was Detector Tested
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Detector Test results
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Detector Make
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Model
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Serial Number
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Detector Date
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Detector Test method
- Spraying or releasing LP or Butane
- Pushing Test Button and Spraying LP or Butane
- Not Tested
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Was Smoke Detector Tested
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Smoke Detector Test results
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Smoke Detector Make
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Model
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Serial Number
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Smoke Detector Date
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Smoke Detector Test method
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Was the Fire Extinguisher Present (1A: 10B:C) 2.5lb
- Yes
- No
- N/A
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Is the Extinguisher at its Proper Charge
Propane Tanks, Lines, and Connections
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Visual condition of tank(s)
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Condition of mounts, brackets, and bolts
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What is the fuel level a the time of inspection
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What is the listed capacity of each tank
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Confirm the proper installation of the regulator(s)
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Was a System Operational 50% Pressure Test performed
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Initial pressure reading of system with 50% load
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Was an adjustment needed for the regulator
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What was the pressure adjusted to
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What was the reading for the Pressure Lockup Test
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Was the Lockup pressure within specifications
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What was the result of the test
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Was a Time Pressure Test Performed
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What was the pressure at the beginning of the test
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What was the pressure at the end of the 15 minute test
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What was the result of this test
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Was a Bubble Leak Test performed after all test equipment was removed
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What was the result of this test
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LP Test Signature
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Is the LP system a DOT type tank or an ASME Tank.
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What is the manufacturer of the ASME tank
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What was the Date of Manufacture
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Is the regulator cover installed
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Is there an "Extended-A-Stay" valve installed
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For DOT tanks, what is the configuration
- Single
- Dual
- Dual Split System
- Triple
- Quad
- None
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What is the size of cylinder #1
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Are there additional Cylinders
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What is the size of cylinder #2
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Are there additional Cylinders
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What is the size of cylinder #3
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Are there additional Cylinders
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What is the size of cylinder #4
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Condition of all flexible hoses and connections
Driveable Units
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Is This a Driveable Unit
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Check condition of wiper blades
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Check oil level
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Oil level good
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Transmission Level Checked
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Transmission level Good
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Engine Coolant level Checked
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Level of Coolant level Good
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Brake fluid Checked
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Level of Brake fluid Good
GENERAL NOTES/COMMENTS
GENERAL NOTES/COMMENTS
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