Western States Fire Protection

• Driver Name:

• Conducted on

  Date

• Vehicle Year, Make, Model.

• VIN Number

• Submitted To:

ADMINISTRATIVE

• Registration & insurance cards are current?

  Yes

  No

  N/A

• License plate and tags are current?

  Yes

  No

  N/A

SAFETY & PROJECT MANAGEMENT

• Foreman's Manual is up to date with claims reporting forms?

  Yes

  No

  N/A

• Foreman's Manual is up to date with national account forms?

  Yes

  No

  N/A

• MSDS binder present & accounted for?

  Yes

  No

  N/A

• Health & Safety Manual in the truck?

  Yes

  No

  N/A

• First Aid kit is complete and items within the expiration date?

  Yes

  No

  N/A

• Fire extinguisher mounted with current inspection tag?

  Yes

  No

  N/A

• Sure off tester and water management tools on truck?

  Yes

  No

  N/A

INTERIOR OF VEHICLE

• Interior clean of trash and dirt?

  Yes

  No

  N/A

• Instrument panel is indicating properly?

  Yes

  No

  N/A

• Windshield and mirrors clean and free from cracks?

  Yes

  No

  N/A

• Please provide a photo of the interior.

  Media

EXTERIOR & MECHANICAL

• Date of last service?

• Backup lights?

  Safe

  At Risk

  N/A

• Belts & Hoses?

  Safe

  At Risk

  N/A

• Brakes? (Pedal Pressure)

  Safe

  At Risk

  N/A

• All Fluid Levels?

  Safe

  At Risk

  N/A

• Oil

• Coolant

• Visible Fluid Leaks?

  Safe

  At Risk

  N/A

• Emergency Flashers?

  Safe

  At Risk

  N/A

• Headlights?

  Safe

  At Risk

  N/A

• Tail Lights?

  Safe

  At Risk

  N/A

• Turn Signals?

  Safe

  At Risk

  N/A

• Horn?

  Safe

  At Risk

  N/A

• Steering & Alignment?

  Safe

  At Risk

  N/A

• Tires & Pressure?

  Safe

  At Risk

  N/A

• Windshield/Wiper Blades/Fluid?

  Safe

  At Risk

  N/A

CARGO & EQUIPMENT (LEAN)

• All equipment is secured & adequately stored?

  Safe

  At Risk

  N/A

• Truck is organized & free of excessive material?

  Safe

  At Risk

  N/A

PLEASE PROVIDE PHOTOS

• Driver's Side.

  Media

• Passenger's Side

  Media

• Bed of truck.

  Media

IF EQUIPPED WITH A TRAILER

• Trailer has been checked for proper connection to the vehicle?

  Safe

  At Risk

  N/A

• Brakes if equipped?

  Yes

  No

  N/A

• Cargo Secure?

  Yes

  No

  N/A

• Lights/Marker Lamps?

  Yes

  No

  N/A

• Springs Appear OK?

  Yes

  No

  N/A

• Straps/Tie Downs?

  Yes

  No

  N/A

• Trailer Tires & Pressure?

  Yes

  No

  N/A

• Trailer Platform Integrity?

  Yes

  No

  N/A

Signature

• Add signature

  Sign