Vehicle Assignment Inspection

• Driver Name

• Conducted on

  Date

• Prepared by

• Branch

  Select Mantua Northfield Middletown Newtown Square Food Safety Burlington Marketing Admin

  • Mantua
  • Northfield
  • Middletown
  • Newtown Square
  • Food Safety
  • Burlington
  • Marketing
  • Admin

• VIN (Last 5#s)

• Year

• Make

• Model

• Mileage

• Plate Number

Documentation

• Inspection Sticker Valid?

  Yes

  No

• Inspection Sticker Expiration Date

• Registration Card In Vehicle?

  Yes

  No

• Registration Expiration Date

• Accident Packet

  Yes

  No

• Gas Card In Vehicle?

  Yes

  No

• Network Maintenance Info In Vehicle?

  Yes

  No

• Insurance Card in Vehicle

  Yes

  No

Tire Pressure/Tire Wear

• Right Front

• Left Front

• Right Rear

• Left Rear

• Spare

• Tread Depth OK?

  Yes

  No

• Tread Wear Even?

  Yes

  No

• Leaks?

  Yes

  No

Oil

• Oil Level

  Full

  Down 1/2 Quart

  Down Full Quart

• Added Oil

  Yes

  No

• How much?

  Select 1/2 Quart One Quart More than one Quart

  • 1/2 Quart
  • One Quart
  • More than one Quart

• Last Oil Change Mileage

Horn/Wipers/Mirrors/Lights/Camera

• Horn/Reverse Sound

  Ok

  Needs Repair

• Wipers & Wiper Blades

  Ok

  Needs Repair

  Needs Replacing

• Mirrors

  Ok

  Needs Repair

• Headlamps/Running Lamps/Reverse Light

  Ok

  Needs Repair

• Brake Lights

  Ok

  Needs Repair

• Backup Camera

  Ok

  Needs Repair

  N/A

• Interior lights / Dashboard Lights

  Ok

  Needs Repair

Ladder Rack

• Rack Functional & Free of Damage?

  Yes

  No

  N/A

• Notes

• Ladder Functional & Free of Damage?

  Yes

  No

  N/A

• Notes

Body and Appearance

• Exterior Free of Body Damage?

  Yes

  No

• Noted on previous reports?

  Yes

  No

  N/A

• Exterior clean?

  Yes

  No

• Interior Clean & Organized?

  Yes

  No

Vehicle Safety Equipment & PPE

• First Aid Kit?

  Yes

  No

• Fire Extinguisher?

  Yes

  No

Safety Road Test / Mechanical

• Brakes

  Ok

  Needs Repair

• Wheel Balance and Alignment

  Ok

  Vibration

  Pull

• Emergency Brake

  Ok

  Needs Repair

• Seat Belt

  Ok

  Needs Repair

• Steering / Play in Wheel

  Ok

  Needs Repair

• Notes

• Seat adjusments working properly?

  Yes

  No

Maintenance

• Oil change up to date?

  Yes

  No

Vehicle Inspection Overall

• Overall Vehicle Condition

  Great

  Good

  Fair

  Poor

Signatures

• Driver Signature

  Sign

• Manager Signature

  Sign