Pre-Trip Inspection

Driver*

First NameLast Name
Truck #*
Date & Time In:*

MonthDayYearHourMinutesAM/PM Option
Mileage In:*
Fuel Gallons*
Walk Around Inspection: (Set parking brake)
Observe under vehicle for any leaks or obstructions*

PassFailOther
Note any dents, scratches or other damage (tampering)*

PassFailOther
Muffler condition and securement*

PassFailOther
Check tire pressures**

PassFailOther
*Windshield washer fluid*

PassFailOther
Check tire treads - 2/32" rear - 4/32" front (including spare)**

PassFailOther
Wheels - bent, loose or missing lug nuts & mud flaps*

PassFailOther
*LIGHTS - head - turn signals - tail - brake - hazard - reverse*

PassFailOther
Clearance, marker, boarding, license, interior lights & reflectors*

PassFailOther
Doors - driver and entrance*

PassFailOther
*Windshield washer fluid*

PassFailOther
Adjust mirrors (ability to view rear tires as well as traffic essential)*

PassFailOther
OPEN HOOD:
*Check/fill with correct motor oil*

PassFailOther
*Radiator overflow container level*

PassFailOther
*Fluids at proper level: Brake & Steering*

PassFailOther
*Windshield washer fluid*

PassFailOther
Battery housing and connections*

PassFailOther
Visible drive belts, wires and hoses*

PassFailOther
Windshield - condition and cleanliness*

PassFailOther
START ENGINE:
*Transmission fluid level*

PassFailOther
*Gauges working*

PassFailOther
*Windshield wipers and blades*

PassFailOther
*Horn*

PassFailOther
*Defroster*

PassFailOther
Heater / Air Conditioner*

PassFailOther
Steering Wheel (no more than 2" of play in a 20" wheel)*

PassFailOther
*Emergency brake stops free rolling vehicle*

PassFailOther
*Back up beeper*

PassFailOther
*Fire Extinguisher - correctly charged, dated & secured*

PassFailOther
*First Aid Kit - proper items & replenished*

PassFailOther
*3 reflectors: complete and in red box*

PassFailOther
Seats & handrails, condition and secure*

PassFailOther
*Seat Belts - functioning*

PassFailOther
*Seat belt cutter - preferably in reach of driver*

PassFailOther
Current Insurance I.D.*

PassFailOther
Current registration & safety inspection sticker*

PassFailOther
Vehicle free of loose objects*

PassFailOther
Overall cleanliness of vehicle*

PassFailOther
Additional Comments:
All asterisked* items MUST PASS or vehicle should not be driven - report pre-trip daily to supervisor. Vehicle should be kept in a secure location and locked every day.
I have personally inspected this vehicle and do hereby certify that all items are safe, repaired or replaced and meet safety standards.
Should be Empty:

Walk Around Inspection: (Set parking brake)

OPEN HOOD:

START ENGINE: