Information
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Location Number
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City, State
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Conducted on
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Prepared by
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Location
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Teammate Name
Company Vehicles & Forklifts
Vehicle Verifications (max 10)
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Add element for each vehicle.
Vehicle
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Vehicle Type
- Service Truck
- Forklift/Cherrypicker/Skidsteer
- Van
- Box Truck
- Trailer
- Salesmen Vehicle
- VAP
- Other
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Driver Name
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Truck Number
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Photograph Vehicle VIN#
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Photograph Vehicle License Plate
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Photograph Vehicle (with DOT# or CA# visible)
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Photograph any special features or damage
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Record Mileage
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Insurance Card?
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DOT Regulation
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Website: http://www.fmcsa.dot.gov/rules-regulations/administration/fmcsr/fmcsrruletext.aspx?reg=387.31
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Medical Card/Name
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DOT Regulation / Company Policy
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Website: http://www.fmcsa.dot.gov/registration-licensing/cdl/faqs.aspx
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Accident Kit?
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Company Policy
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Steering Wheel Covers?
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Cheetah?
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Cheetah Gauge?
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6' Whip?
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If the vehicle has a crane, was it inspected by a certified crane inspector in the last 12 months?
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OSHA Requirement
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Website: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=142
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Inflation Cage?
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OSHA Requirement
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Website: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9825
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Are TIA 300 CTS (Commercial Tire Service) books kept in all service trucks?
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Are TIA ETS (Earthmover Tire Service) 200 manuals in the service trucks that service OTR tires and all service trucks working on MSHA property?
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Do they also have the store specific “Part 46” plan in all trucks that work on MSHA properties?<br><br><br><br>BMS locations must have a copy of the “Part 48” plan in their files as well as in all trucks that work on MSHA properties. (BMS locations are not required to have a “Part 46” plan.)
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Are there MSDS sheets for chemicals (by Brand) sampled (10)?
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MSHA Requirement / Company Policy
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Website: http://www.msha.gov/30cfr/47.11.htm
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Are pre-trip inspection forms kept for the current month +1 in the truck?
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DOT Regulation
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Website: http://www.fmcsa.dot.gov/rules-regulations/administration/fmcsr/fmcsrruletext.aspx?reg=396.11
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Is everything (merchandise, tools, equipment, etc.) hauled on company vehicles or vehicles in the VAP program properly secured?
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Are tire bars in good condition? Any bent, damaged or modified bars should be scrapped.
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Company Policy
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Photograph Vehicle
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Fire Extinguisher?
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MSHA Requirement / DOT Regulation
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Website: http://www.msha.gov/REGS/FEDREG/TECHAMEND/2003/03-13498.pdf
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Website: http://www.fmcsa.dot.gov/rules-regulations/administration/fmcsr/fmcsrruletext.aspx?reg=393.95
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Fire Extinguisher monthly checks complete?
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Fire Extinguisher annual check complete?