Title Page
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Site conducted
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Unit #/Driver Name
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Last 4 of VIN
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Current Mileage
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License Plate Number
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Apportion Plate
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Valid IFTA Stickers (2)
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Conducted on
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Location
Front of Vehicle
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Front Four-Way Flashers
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Clearance Lights
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Front Side Marker Lights
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Low Beam
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High Beam
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Front Turn-Signals Work/Amber
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Horn (City or Air Horn Must Work)
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Wipers Work
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Wiper Fluid Sprays
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Windshield Damage Regulated Area
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MISC
Driver Side
Driver Side Cab Area
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(DS) Steer Tire-Wheel Inflated/Damage/Lugs/Cracks/Hub
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(DS) Steer Tire Tread Depth 4/32
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(DS) Mirror
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(DS) Company Name, US DOT#, City, State and Unit #
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(DS) Fuel Tank and Filler Cap Secured
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(DS) Fuel Tank Straps Secured
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(DS) Top Cab Corner L Shape Clear Reflector
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(DS) Exhaust Leak Under Cab
Driver Side CAT Walk Area
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(DS) Cat Walk & Steps Free of Obstructions/Loose Items
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Air and Electrical Line Secured (Not Laying On Catwalk)
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Gladhand Gaskets Good - Red/Blue
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Electrical Pigtail Connection
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(DS) Cabin Air Bags
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(DS) Drive Shaft U-Joints
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(DS) Fifth Wheel Bolts Secured/Missing
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(DS) Fifth Wheel Cracks/Hole(s)
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Fifth Wheel Locking Mechanism
Driver Side Front Drive Axle Area
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(DS) Front Drive Tire-Wheel - Outer Inflated/Damage/Lugs/Cracks/Hub
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(DS) Front Drive Tire - Outer Tread Depth 2/32
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(DS) Front Drive Tire-Wheel Inner Inflated/Damage/Lugs/Cracks/Hub
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(DS) Front Drive Tire Inner Tread Depth 2/32
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(DS) Front Drive Spring Mounts/U-Bolts/Leafs/Shock
Driver Side Back Drive Axle Area
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(DS) Back Drive Tire-Wheel - Outer Inflated/Damage/Lugs/Cracks/Hub
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(DS) Back Drive Tire - Outer Tread Depth 2/32
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(DS) Back Drive Tire-Wheel Inner Inflated/Damage/Lugs/Cracks/Hub
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(DS) Back Drive Tire Inner Tread Depth 2/32
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(DS) Back Drive Spring Mounts/U-Bolts/Leafs/Shock
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(DS) Chaffing Hoses/Lines
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(DS) Audible Air Leaks
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MISC
Back of Vehicle
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Back Four-Way Flashers
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Tail Lights
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Brake Lights
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Left Turn Signal
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Right Turn Signal
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Reverse Light
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Mud Flaps On Both Sides
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Mud Flaps Reflective Material/Tape/or Bottom of Cab
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Torque Arm From Frame to Rear Axle Tight
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MISC
Passenger Side
Passenger Side Back Drive Axle Area
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(PS) Back Drive Tire-Wheel - Outer Inflated/Damage/Lugs/Cracks/Hub
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(PS) Back Drive Tire - Outer Tread Depth 2/32
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(PS) Back Drive Tire-Wheel Inner Inflated/Damage/Lugs/Cracks/Hub
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(PS) Back Drive Tire Inner Tread Depth 2/32
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(PS) Back Drive Spring Mounts/U-Bolts/Leafs/Shock
Passenger Side Front Drive Axle Area
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(PS) Front Drive Tire-Wheel - Outer Inflated/Damage/Lugs/Cracks/Hub
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(PS) Front Drive Tire - Outer Tread Depth 2/32
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(PS) Front Drive Tire-Wheel Inner Inflated/Damage/Lugs/Cracks/Hub
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(PS) Front Drive Tire Inner Tread Depth 2/32
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(PS) Front Drive Spring Mounts/U-Bolts/Leafs/Shock
Passenger Side CAT Walk Area
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(PS) Cat Walk & Steps Free of Obstructions/Loose Items
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(PS) Cabin Air Bags
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(PS) Fifth Wheel Bolts Secured/Missing
Passenger Side Cab Area
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(PS) Exhaust Leak Under Cab
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(PS) Top Cab Corner L Shape Clear Reflector
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(PS) Fuel Tank Straps Secured
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(PS) Fuel Tank and Filler Cap Secured
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(PS) Company Name, US DOT#, City, State and Unit #
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(PS) Mirror
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(PS) Steer Tire-Wheel Inflated/Damage/Lugs/Cracks/Hub
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(PS) Steer Tire Tread Depth 4/32
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(PS) Chaffing Hoses/Lines
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(PS) Audible Air Leaks
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MISC
Under Hood
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Hood Latch
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Coolant Level
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Washer Fluid Level
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Belts
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Oil Leaks
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Hose and Fitting Fluid Leaks
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(DS) Steering Components 3 Castle Nuts and Cotter Pins
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(DS) Spring Mounts/U-Bolts/Leaf/Shock
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Drag Link
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Steering Shaft/Joints
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Pitman Arm
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Audible Air Leaks
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MISC
Brakes - steer air port round (1 3/4) square (2) - Drives/Trailer round (2) square (2 1/2)
Driver Side Steer Brake Equipment
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(DS) Steer Brake Chamber Intact & Not Leaking Air
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(DS) Steer Brake Chamber Air Line
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(DS) Steer Brake Drum & Pads
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(DS) Steer Brake Rod Travel Distance Measurement
Pasenger Side Steer Brake Equipment
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(PS) Steer Brake Chamber Intact & Not Leaking Air
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(PS) Steer Brake Chamber Air Line
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(PS) Steer Brake Drum & Pads
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(PS) Steer Brake Rod Travel Distance Measurement
Driver Side Front Drive Axle Brake Equipment
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(DS) Front Drive Brake Chamber Intact & Not Leaking Air
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(DS) Front Drive Brake Chamber Air Line
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(DS) Front Drive Brake Drum & Pads
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(DS) Front Drive Brake Rod Travel Distance Measurement
Driver Side Back Drive Axle Brake Equipment
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(DS) Back Drive Brake Chamber Intact & Not Leaking Air
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(DS) Back Drive Brake Chamber Air Line
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(DS) Back Drive Brake Drum & Pads
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(DS) Back Drive Brake Rod Travel Distance Measurement
Passenger Side Front Drive Axle Brake Equipment
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(PS) Front Drive Brake Chamber Intact & Not Leaking Air
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(PS) Front Drive Brake Chamber Air Line
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(PS) Front Drive Brake Drum & Pads
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(PS) Front Drive Brake Rod Travel Distance Measurement
Passenger Side Back Drive Axle Brake Equipment
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(PS) Back Drive Brake Chamber Intact & Not Leaking Air
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(PS) Back Drive Brake Chamber Air Line
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(PS) Back Drive Brake Drum & Pads
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(PS) Back Drive Brake Rod Travel Distance Measurement
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MISC
Cabin/Interior
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Seat Belt
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Fire Extinguisher Secured
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Fire Extinguisher Charged
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Safety Triangles
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Spare Fuses and Bulbs
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Defroster Working
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Check Engine Light On
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Tractor Protection System Test (90psi/buttons in/pump brake/warning/pop out)
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MISC
Vehicle Paperwork Book
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State Registration Valid
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State Commercial Inspection Valid
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Carrier Authority
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Current Insurance Paperwork
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IFTA Paperwork
HOS
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Does Driver Use ELD for HOS
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ELD Mounted
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ELD Instruction Sheet
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Blank Log Book (8 days worth)
Equipment Photos
Photo of Truck
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Add media
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Additional Notes
