Information
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Document No.
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Unit Number / Month
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Conducted on
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Location
First Page
Vehicle Information
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Vehicle Info: (Scan QR Code)
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Odometer?
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Signature:
Lights
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Headlights
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Low Beam
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High Beam
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Front Turn Signals
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Tail Lights
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Brake Lights
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Rear Turn Signals
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Emergency Flashers
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Backup Lights
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Work Lights / Headache Rack
Second Page
Glass
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Windshield
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Mirrors
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Drivers Windows
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Passenger Windows
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Rear Windows
Interior
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Seatbelts
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Horn
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Computer Stand
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2-Way Radio
Mechanical
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Engine
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Transmission
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Exhaust
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Front End
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Rear End
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Shocks
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Oil Change Current
Third Page
Tires
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Right Front
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Left Front
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Right Rear
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Left Rear
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Spare
EH&S
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Fire Extinguisher
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First Aid Kit
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BBP Kit
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Flag & Whip
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LOTO Kit
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Vehicle Accident Kit
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Respirator
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Respirator Inspected
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Emergency Response Plan
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XTO Safety Handbook
Fourth Page
House Keeping
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Vehicle Washed
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Cab Interior
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Bed Interior
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Body Damage
General
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Registration / Sticker
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Insurance Card current?<br>
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How many tribal permits do you carry?
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List Tribe and expiration date of each.
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License Plate Light
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Radio Unit # Stickers
