Fleet Inspection Form

Fleet Inspection Form

Truck and Trailer (The trailer inspection will show when you answer Yes)
NOTE:

By applying your name to this inspection you are acknowledging that this vehicle has been inspected in accordance with Section 10 of the Commercial Vehicle Safety Regulation (AR121/2009)
Name of person inspecting*
Plate Number*
Date*

DayMonthYear
Date
Odometer Reading*
Are the following systems in good working order?

If you find an item that is non-compliant, please add it to the corrective action list below!
Oil Level

CompliantNon Compliant
Brake Fluid Level

CompliantNon Compliant
Radiator Fluid Level

CompliantNon Compliant
Windshield Washer Level

CompliantNon Compliant
Seatbelts - check all for operation

CompliantNon Compliant
Gearshift - shifts smoothly without jumping or jerking

CompliantNon Compliant
Parking Brake Works Correctly

CompliantNon Compliant
Mirrors - clean and operable

CompliantNon Compliant
Door and Doorlocks

CompliantNon Compliant
Steering - moves smoothly and easily

CompliantNon Compliant
Headlights - low beam & hi beam

CompliantNon Compliant
Brake Lights In Working Order

CompliantNon Compliant
Misc Lights - reverse, side, license plate, turn signals

CompliantNon Compliant
Guages and Dash Lights

CompliantNon Compliant
Horn In Working Order

CompliantNon Compliant
Marker Flag is in good condition and stows correctly

CompliantNon CompliantN/A
Beacon Lights Operational

CompliantNon CompliantN/A
Corrective Actions
Is there a trailer attached to this unit*

YesNo

Fleet Inspection Form

Corrective Actions