Title Page

  • Client

  • Vehicle

  • Tag #

  • Milage

  • Operator

  • Date (Ist day of the work week)

  • Location


  • techdatabanner.PNG
    1. Please answer "Yes", "No" or "N/A" on the questions below
    2. Add photos and notes by clicking on the paperclip icon
    3. To add a Corrective Action click on the paperclip icon then "Add Action," provide a description, assign to a member, set priority, and due date
    4. Complete audit by providing digital signature
    5. Share your report by exporting as PDF, Word, Excel or Web Link

    "Yes" - item meets inspection standards
    "No" - item is damaged and requires attention


  • Headlights- High and Low Beam

  • Brake Lights

  • Parking / Tail Lights

  • Turn Signals

  • Four Way Emergency Lights


  • At least 1 MM of tread over the entire traction surface

  • Free of breaks or cuts

  • Properly inflated

  • Spare tire properly inflated, free of breaks or cuts

  • Jack & Lug wrench


  • Windshield free of cracks

  • Windows operational, free of cracks

  • Mirrors free of cracks

Climate control

  • Defroster in working order

  • Heating system in working order

  • Air Conditioning system in working order

Emergency Equipment / Paperwork

  • Fire extinguisher accessible & up to date / Visual Inspection

  • First Aid Kit accessible / stocked

  • Accident Report Form in glove box

  • Registration in glove box

  • Insurance paperwork in glove box


  • Bumpers not bent or damaged in a hazardous way

  • Under vehicle-check for leaks and foreign objects

  • Seat belts in working order

  • Brakes in working order, not grinding or squealing

  • Parking Brake in working order

  • Exhaust system not rusted, no visible holes

  • Safety equipment present / working order

  • Hand Truck inspection (wheels, welds / general good condition)

  • Horn in working order

  • Fluid levels full

  • Hoses and Belts in good condition


  • I certify the above items were inspected on the date indicated

  • Operator's Name and Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.