Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Fleet Vehicle Inspection Form:

  • Select date

Summit Utilities, Inc:

  • Summit Natural Gas of Maine, Inc

  • Summit Natural Gas of Missouri, Inc

  • Colorado Natural Gas, Inc

Vehicle Information:

Driver:

Vehicle / Equipment #

Vin #

Location:

Vehicle / Equipment Make:

Odometer / Hour Reading:

Vehicle Inspection Report:

  • Body Dented

  • Body Scratched

  • Is there any damage to the headlights

  • Is there any damage to the tail lights

  • Is there any damage to the windshield

  • Is there any damage to the front grill

  • Is there any damage to the hood

  • Is there any damage to the front passenger door

  • Is there any damage to the front drivers door

  • Is there any damage to the rear passenger door

  • Is there any damage to the rear drivers door

  • Is there any damage to the mirrors

  • Is there any damage to the windows

  • Is there any damage to the front fenders

  • Is there any damage to the rear fenders

  • Is there any damage to the rear window

  • Is there any damage to rear bumper

  • Is there any damage to the truck bed

  • Is there any damage to the tailgate

  • Is there any damage to the roof

Condition of tires:

  • Remaining tread depth of right front tire

  • Remaining tread depth of left front tire

  • Remaining tread depth of right rear tire

  • Remaining tread depth if left rear tire

Interior:

  • Is the dash worn or need repair

  • Is the drivers seat worn or need repair

  • Is the passenger seat worn or need repair

  • Is the back seat worn or need repair

  • Are the floor covering worn or need repair

  • Are any of the interior panels worn or need repair

Mechanics:

  • Is the steering system in good condition

  • Is the battery in good condition

  • Is the motor in good condition

  • Is the suspension in good condition

  • Is the differential in good condition

  • Are the brakes in good condition

  • Is the transmission / clutch in good condition

  • Is the starter in good condition

  • Is the cooling system in good condition

  • Is the exhaust system in good condition

  • Is the fuel system in good condition

  • Are the hydraulic hoses in good condition

  • Are the windshield wipers in good condition

  • Is the horn working properly

  • Is the heater working properly

  • Are all of the lights working properly

Fire extinguisher:

  • What month is the annual inspection due

  • Have the monthly inspections been completed

First aid kit:

  • Is it available and stocked

Maintenance: What date was the last oil change

  • Select date

What date is the next scheduled oil change

  • Select date

Tire rotation:

  • Have the tires been rotated every 5,000 miles

Are there any repairs scheduled:

  • Is the condition of the above vehicle satisfactory

  • Above defects corrected and paperwork attached

  • Above defects need not be fixed for safe operation of vehicle equipment

Please attach any maintenance paperwork receipts to this report:

Drivers signature:

  • Add signature

Managers or Safety Department signature:

  • Add signature

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