Title Page
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Driver Name
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Conducted on
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Prepared by
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Branch
- Mantua
- Northfield
- Middletown
- Newtown Square
- Food Safety
- Burlington
- Marketing
- Admin
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VIN (Last 5#s)
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Year
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Make
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Model
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Mileage
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Plate Number
Documentation
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Inspection Sticker Valid?
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Inspection Sticker Expiration Date
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Registration Card In Vehicle?
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Registration Expiration Date
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Accident Packet
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Gas Card In Vehicle?
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Network Maintenance Info In Vehicle?
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Insurance Card in Vehicle
Tire Pressure/Tire Wear
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Right Front
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Left Front
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Right Rear
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Left Rear
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Spare
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Tread Depth OK?
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Tread Wear Even?
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Leaks?
Oil
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Oil Level
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Added Oil
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How much?
- 1/2 Quart
- One Quart
- More than one Quart
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Last Oil Change Mileage
Horn/Wipers/Mirrors/Lights/Camera
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Horn/Reverse Sound
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Wipers & Wiper Blades
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Mirrors
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Headlamps/Running Lamps/Reverse Light
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Brake Lights
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Backup Camera
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Interior lights / Dashboard Lights
Ladder Rack
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Rack Functional & Free of Damage?
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Notes
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Ladder Functional & Free of Damage?
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Notes
Body and Appearance
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Exterior Free of Body Damage?
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Noted on previous reports?
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Exterior clean?
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Interior Clean & Organized?
Material Labeling, Spillage & Storage
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Are all materials labeled properly?
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Is there any spillage?
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Notes
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Are Insect Baits stored away from Chemical & sealed?
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Notes
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Are all materials & equipment stored & secured properly?
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Notes
Vehicle Safety Equipment & PPE
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First Aid Kit?
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Fire Extinguisher?
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PPE Stored Properly?
Safety Road Test / Mechanical
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Brakes
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Wheel Balance and Alignment
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Emergency Brake
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Seat Belt
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Steering / Play in Wheel
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Notes
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Seat adjusments working properly?
Vehicle Inspection Overall
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Overall Vehicle Condition
Maintenance
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Oil change up to date?
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Tires rotated at last oil change?
Long Term Check-ups Due (As per Owner's Manual)
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Notes:
Gas Card Usage
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Card being used properly?
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Is gas card being used to frequent compared to miles driven?
Material Usage Validation
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Run a material usage report from previous month & review
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Are materials given out matching what's being used?
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Are materials being used correctly?
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Are materials unaccounted for?
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Are there excess materials / chemicals on vehicle that were not given by manager?
Signatures
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Driver Signature
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Manager Signature