Vehicle Inspection Report 1.5

• Vehicle Inspection Report

• Document No.

• Conducted on

  Date

• Prepared by

• First Aid Kit in truck is current without expired contents?

  Yes

  No

  N/A

• Spare Tire properly inflated?

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Fire Extinguisher Charged

  Yes

  No

  N/A

• Fire Extinguisher tagged and inspected within the past thirty days?

  Yes

  No

  N/A

• Fire Extinguisher in good condition

  Yes

  No

  N/A

• Tools for changing wheel are on truck?<br>

  Yes

  No

  N/A

• Office Location

• Vehicle make:

• License plate number:

• License plate expiration:

• Current Miles on Vehicle:

FRONT END OF VEHICLE

• Headlights (high/low beam) operational

  Yes

  No

  N/A

• Hazard Lights operational

  Yes

  No

  N/A

• Turning signals (left & right) operational

  Yes

  No

  N/A

• Wiper Blades operational

  Yes

  No

  N/A

• Front grill free of debris operational

  Yes

  No

  N/A

REAR END OF VEHICLE

• Tail lights operational

  Yes

  No

  N/A

• Brake lights operational

  Yes

  No

  N/A

• Turning signals (left & right) operational

  Yes

  No

  N/A

• Reversing lights operational

  Yes

  No

  N/A

• Number plate light operational

  Yes

  No

  N/A

MAINTENANCE

• Next service is due at what mileage? (3000 miles since last service).

  Yes

  No

  N/A

• Current engine oil level?

  Safe

  At Risk

  N/A

• Engine coolant reservoir coolant level is between COLD and HOT as appropriate?

  Safe

  At Risk

  N/A

• Brake fluid level

  Safe

  At Risk

  N/A

• Windscreen washer fluid level

  Safe

  At Risk

  N/A

• Battery terminal condition

  Safe

  At Risk

  N/A

• Parking Brake Functional?

  Safe

  At Risk

  N/A

TIRES

• Do the tires appear to have correct air pressure?

  Yes

  No

  N/A

• Are all 4 tires a matched set that is correct size and type for this vehicle according to manufacturer's recommendations?

  Yes

  No

  N/A

• Do any of the tires appear damaged, missing tread, cuts on sidewall, or show uneven wear pattern?

  Yes

  No

  N/A

INTERIOR CONDITION

• Floor materials clean with no rips, tears, holes or large amounts of debris? Garbage cleaned out?

  Safe

  At Risk

  N/A

• Seats free from stains, rips, tears or other defects?

  Yes

  No

  N/A

• Interior lighting functional

  Yes

  No

  N/A

• Heater/Air Conditioning functioning properly?

  Yes

  No

  N/A

• Are all seat belt restraints in a functional capacity?

  Yes

  No

  N/A

EXTERIOR/BODY CONDITION

• Washed recently?

  Safe

  At Risk

  N/A

• Is paint scratched?

  Yes

  No

  N/A

• Are there any dents or damage?

  Yes

  No

  N/A

• Are all markings/letterings legible and intact?

  Yes

  No

  N/A

• Are all state and federal marking present as required by state DOT regulations?

  Yes

  No

  N/A

GLASS AND MIRRORS

• Is the windshield free from cracks, rock chips or webbing, and pitting?

  Yes

  No

  N/A

• Wipers in good condition?

  Yes

  No

  N/A

• Side windows intact, close properly, free from scratches?

  Yes

  No

  N/A

• Side mirrors intact and free from damage?

  Yes

  No

  N/A

• Rear windows (if applicable) intact, free from scratches/breaks?

  Yes

  No

  N/A

LOAD SECUREMENT

• Has the roof rack/ladder rack/pipe rack been inspected?

  Yes

  No

  N/A

• Are ladders, pipe and other equipment been secured to prevent dislodgement? (No rubber straps or bungee cords being utilized, only rachet type straps)

  Yes

  No

  N/A

• Have ladders been inspected for damage/ UV degradation?

  Yes

  No

  N/A

• Is there a cylinder rack inside the vehicle and has it been inspected?

  Yes

  No

  N/A

• Are tanks and cylinders properly secured to prevent dislodgement? (No rubber straps or bungee cords being utilized, only rachet type straps)

  Yes

  No

  N/A

• Are all cylinders properly capped while in transport and are they separated if necessary?

  Yes

  No

  N/A

COMMENTS

• Comments about this vehicle?

  Yes

  No

  N/A

SIGNATURE OF INSPECTOR/OPERATOR

• OPERATOR

  Sign

• INSPECTOR

  Sign