Van Safety Checklist
Vehicle
Year
Make
Model
License
Mileage
Exterior Inspection
Visually inspection
Fluid leaks
Loose parts
Leaning to one side
Other
Damage check
Windshield & windows
Exterior body & light lens
Side mirrors
Wiper blades
Other
Tires Check
Use a gauge & owner’s manual/doorsill specs
Tread depth?
Uneven wear, cracks or damage?
Check spare tire
Other
Engine compartment inspect
Oil
Radiator (when engine is cool)
Windshield wiper fluid
Hoses and cable connections
Belts or hoses (frayed/cracked?)
Other
Exterior lights check
Headlights
Tail lights
Brake lights
Reverse lights
Turn signals
Emergency Flashers
Other
Interior Inspection
Inspect interior
Interior lighting
Seats condition
Cleanliness of seats and floor
Present and operable safety restraints
Floor clear of loose items & debris
Other
Equipment and safety items check
Dashboard indicator lights & gauges
A/C – Heater
Horn
Windshield wipers & washer fluid
Backup alarm (if installed)
Parking brake
Jack & lug wrench
Fire extinguisher
First Aid kit (if installed)
Road service kit (if installed)
Insurance liability card & accident forms
Other
Driver adjustments
Adjust seat to reach pedals, steering wheel, etc.
Adjust steering wheel height/distance
Adjust mirrors to reduce blind spots
Other
Before operating the van
Put on your safety restraint
Ensure all passengers are buckled up
Secure & lock doors
Other
On the road
ABS/EBS warning lights off
Other
Defects
Please list all the defects (If any)
Date
-
Month
-
Day
Year
Date
Inspected by
First Name
Last Name
Signature
Soumission
Should be Empty: