Vehicle Pre Trip Inspection

• Conducted on

  Date
• Location
  Address

• Prepared by

• Document No.

Vehicle ID:

• Choose which vehicle is being inspected:

Exterior walk around Observations:

• Reflectors

  Good

  Fair

  Poor

  N/A

• Describe what is observed, possible cause of unsatisfactory condition:

  Yes

  No

  N/A

• Roof

  Good

  Fair

  Poor

  N/A

• Tires - tread is good, no gashes in sidewall, Wheel and Lug Nuts Secure - visual and kick tire

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

• Wheels/Rims Not bent or Cracked

  Good

  Fair

  Poor

• Are Mirrors clean, and free of cracks or breakage.

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

• Windshield and Wipers condition:

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

Under the Hood Observations:

• Are any new Fluid Leaks Observed

  Yes

  No

• Describe what is observed, possible cause of unsatisfactory condition:

• Oil Level on the dipstick.

  Good

  Fair

  Poor

• Describe what is being done about the unsatisfactory condition:

• Radiator/Coolant Level

  Good

  Fair

  Poor

• Describe what is being done about the unsatisfactory condition:

• Washer Fluid - level

  Good

  Fair

  Poor

• Describe what is being done about the unsatisfactory condition:

• Brake Fluid Level

  Good

  Fair

  Poor

• Describe what is being done about the unsatisfactory condition:

• Battery & Electrical - Connections/Corrosion

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

Interior Observations & Condition

• Odometer Reading

• Fuel Level

• Defrost / Heater / AC

  Yes

  No

  N/A

• Oil Pressure

  Yes

  No

  N/A

• Yes

  No

  N/A

• Are Mirrors adjusted properly for you..?

  Yes

  No

• Describe what is observed, possible cause of unsatisfactory condition:

• Driver's Floor Mat in place and secure (ie. gas pedal cannot get stuck)

  Yes

  No

• Describe what is observed, possible cause of unsatisfactory condition:

• Emergency Brake Working - test engage pedal and put truck in gear (does it move?)

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

• Seat Belts - Fraying, good movement in and out of retraction box

  Good

  Fair

  Poor

• Describe what is observed, possible cause of unsatisfactory condition:

Checklist the **Lights** that are working properly

• Brake Lights, & Signal Lights, front and back

• Park Lights

• Head Lights

• Horn

Checklist the **Operating and Safety Equipment** onboard:

• Coupling Devices / Pin

• First Aid Kit (Stocked)

• Fire Extinguisher present & fully Charged

Seasonal Safety Equipment & Tools Checklist

• Seasonal Equipment list for

  Summer

  Winter

Summer

• Roadside Emergency Kit

Winter

• Window Scraper?

• Warm Cloths

• Roadside Emergency Kit

General Vehicle Observations or Comments:

• Additional Comments

Declaration of Vehicle Condition:

• This vehicle is

  Safe to Drive

  Requires Attention

  UNSAFE

• Signature

  Sign