Title Page
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Conducted on
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Prepared by
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Location
Unit #'s on location
Drivers on Location
Stickers- Calcamonias
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DOT Stickers- Numero de DOT
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Logo
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WHP #
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Phone #- Numero de telefono
Lights- Luces
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Turn Signals- Luces direccionales
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Work Lights- Luces de Trabajo
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Brake Lights- Luces de Frenos
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Headlights
Tires- Llantas
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Pressure- Presion
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Tread- 4/32 front & 2/32 back
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Mudflaps
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Tread- 4/32 front & 2/32 back
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Tread- 4/32 front & 2/32 back
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Tread- 4/32 front & 2/32 back
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Tread- 4/32 front & 2/32 back
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Tread- 4/32 front & 2/32 back
Reflectors- Reflectores
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On Truck- En la troca
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On Tank- En el tanque
Brakes- Frenos
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Pads
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Air
Fluids
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Hydraulic
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Motor Oil
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Vac Pump
Leaf Springs
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Cracked
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Shifted
Leaks
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Valve
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Wheel Seal
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Air
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Hoses
Grounding
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Grounding
Safety Equipment
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Fire Extinguisher
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Cones
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Triangles
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Chocks
Paperwork
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Registration
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Insurance
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Inspection
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MCS 90
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NM DOT
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WH Permit
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Weight and Distance
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2290
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PRC
Inventory
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Hoses
- 2''
- 3''
- No
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Fitting
Personal Protective Equipment
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Hard Hat
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Did you buy it
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H2S Monitor
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Did you buy it
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FR Clothes
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Did you buy it
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Glasses
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Did you buy it
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Boots
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Did you buy it
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Gloves
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Did you buy it
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Hearing Protection
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Did you buy it
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First Aid Kit
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Did you buy it
Purchase- Compras
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Did you buy food- Compro usted comida
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Attach receipt picture(s)- Tome foto de recibo(s)
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Did you stay at a hotel- Se quedaron en hotel
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Who - Quien
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Where and what room- Que hotel y cual cuarto
Incidents and Accidents
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Was there any incidents and/ or accidents- Hubo algun incidente o accidente
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Who was involved
Disposal and / or Water Stations
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What Disposal and or Water Station were you using- Que disposals o estaciones de agua estaban usando
Supervisor Check In
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Did you talk to Miguel Contreras today- Se comunico con Miguel Contreras
Diesel Purchase
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Did you fill up a truck with your auxiliary tank?- Lleno una troca con el tanque extra
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Which one and how much- Cuales y cuanto
Notes
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Do you have any extra notes- Tiene alguna nota extra
