TRUCK SAFETY INSPECTION

• Site conducted

  Select

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Inspection Date/Time

  Date

• Van #

Physical

• Vehicle serviced according to schedule

  Good

  Fair

  Poor

  N/A

• Engine in good working condition

  Good

  Fair

  Poor

  N/A

• Headlights operational

  Good

  Fair

  Poor

  N/A

• Turn signals operational

  Good

  Fair

  Poor

  N/A

• Break lights operational

  Good

  Fair

  Poor

  N/A

• Vehicle body in good condition

  Good

  Fair

  Poor

  N/A

• Tires in good condition

  Good

  Fair

  Poor

  N/A

• Spare Tire

  Good

  Fair

  Poor

  N/A

• Eagle eye/back-up camera working properly

  Good

  Fair

  Poor

  N/A

• Truck bed and cab clean and organized

  Good

  Fair

  Poor

  N/A

• Volt plug in working condition

  Good

  Fair

  Poor

  N/A

• Original Odometer Reading

Documentation

• Insurance Expiration Date

  Date

• DL expiration Date

  Date

• Registration Expiration Date

  Date

• Last Oil Change Date

  Date

Safety Items

• First aid kit stocked and up to date

  Yes

  No

  N/A

• Hazard cones available and in good condition

  Yes

  No

  N/A

• 6 ft Ladder inspected and in good condition

  Yes

  No

  N/A

• Change of clothes available and in good condition

  Yes

  No

  N/A

List any other action items that need to be Fixed

• Enter/list issues here.

Sigatures

• Employee

  Sign

• Manager

  Sign